合并焦虑和(或)抑郁的急性心肌梗死患者的危险因素分析  

Risk factors in patients with acute myocardial infarction combined with anxiety or depression

作　　者：蒲连美[1] 李瑛 李红[2] 李响[1] 韩福生[1] 阮杨 金泽宁[2] PU Lian-Mei;LI Ying;LI Hong(Department of Emergeney Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessels, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,北京市100029 [2]首都医科大学附属北京安贞医院心内科,北京市100029 [3]神经心理学与应用认知神经科学实验室,中国科学院心理研究所,中国科学院大学心理学系,北京市海淀区精神卫生防治院

出　　处：《中国心血管病研究》2018年第6期505-509,共5页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金(项目编号:81570323)

摘　　要：目的 初步分析合并焦虑和（或）抑郁的急性心肌梗死（AMI）患者的危险因素。方法 筛选有“心绞痛”症状同时合并焦虑和（或）抑郁的患者150例，根据辅助检查结果分为AMI组50例和非冠心病组100例，设非冠心病组为对照组。分析两组临床资料、焦虑和（或）抑郁的分布情况，采用Logistic回归筛选合并焦虑和（或）抑郁的AMI患者的危险因素。结果 AMI组和对照组患单纯焦虑状态的比例均较高（40%比45%，P〉0.05）；AMI组较对照组患有较高比例的抑郁状态（44%比21%，P=0.003），而患混合型焦虑抑郁状态者少于对照组（16%比34%，P=0.02）。 AMI组患焦虑和（或）抑郁状态的病程明显长于对照组［（10.1±9.7）年比（7.4±5.6）年，P=0.032］。Logistic分析结果显示，单纯抑郁（OR=3.29，P=0.013）、配偶或父母患慢性疾病（OR=3.01，P=0.015）及左室射血分数（OR=0.84，P〈0.01）三个因素与AMI患者合并焦虑和（或）抑郁具有相关性。结论 单纯抑郁、配偶或父母患慢性疾病及心功能受损是合并焦虑和（或）抑郁的AMI患者的独立危险因素。Objective To analyze risk factors in patients with acute myocardial infarction combined with anxiety or depression. Methods The study subjects comprised 150 inpatients who were diagnosed with anxiety and/or depression symptoms, 50 with acute myocardial infarction（AMI group） and 100 with susceptive angina pectoris but negative coronary angiography（control group）. Anxiety and depression were measured by psychiatrists. Multiple regression was used to determine related risk factors of AMI combined with anxiety or depression. Results 40% of AMI patients and 45% of control subjects were at risk for anxiety, respectively（P〉0.05）. There was a higher proportion of depression in AMI group than in control group（44% vs 21%, P=0.003）. The proportion of anxiety co-occurring depression was 16% in AMI group versus 21% in control group（P=0.02）. AMI patients had a longer course of psychological distress than that in control subjects[（10.1±9.7）years vs （7.4±5.6）years, P=0.032]. Depression（OR=3.29, P=0.013）, spouse or parents having chronic disease（OR=3.01, P=0.015）, left ventricular ejection fraction（OR=0.84, P〈0.01） were significantly associated with AMI combined with anxiety or depression. Conclusion Depression, spouse or parents having chronic diseases, impaired cardiac function are risk factors for patients with acute myocardial infarction combined with anxiety or depression.

关 键 词：急性心肌梗死 冠状动脉造影阴性 抑郁 焦虑 

分 类 号：R542.22[医药卫生—心血管疾病]