永久人工心脏起搏器植入术后抑郁患者与血清同型半胱氨酸和高敏C反应蛋白水平的关系研究  

Relationship between serum levels of Hcy and hs-CRP in patients with depression after permanent artificial cardiac pacemaker implantation

作　　者：熊三军[1] 马江 乔增勇 Xiong Sanjun;Ma Jiang;Qiao Zengyong(Department of Cardiology,Shanghai Jiaotong University Affiliated Sixth People′s Hospital South Campus,Shanghai 201400,China)

机构地区：[1]上海交通大学附属第六人民医院南院心内科,201400 [2]上海市奉贤区中心医院心内科

出　　处：《山西医药杂志》2019年第7期774-777,共4页Shanxi Medical Journal

摘　　要：目的探讨永久人工心脏起搏器植入术后抑郁患者与血清同型半胱氨酸(Hcy)和高敏C反应蛋白(hs-CRP)水平的关系。方法纳入2015年1月至2018年2月在本院心内科行永久人工心脏起搏器植入术的患者78例,术后3个月随访,发放汉密尔顿24项抑郁量表(HAMD)问卷调查,将HAMD评分>8分以上的纳入抑郁组,HAMD评分≤8分的纳入对照组,统计2组一般资料,并检测患者血清Hcy和hs-CRP水平,分析永久人工心脏起搏器植入术后患者抑郁的危险因素。结果本研究78例患者中,26例患者行永久人工心脏起搏器植入术后出现抑郁,抑郁发生率为33%。2组患者性别、年龄、文化程度、已婚、吸烟、合并糖尿病、合并高血压一般资料比较差异无统计学意义(P>0.05);2组患者经济收入、合并2种以上疾病、负性生活事件、心律失常方面比较差异有统计学意义(P<0.05),抑郁组患者血清Hcy和hs-CRP水平分别为(31±10)μmol/L、(10.5±1.7)mg/L,均显著高于对照组的(13±5)μmol/L、(2.1±1.0)mg/L;Logistic回归分析发现,负性生活事件、心律失常、Hcy>15μmol/L、hs-CRP>10 mg/L为术后抑郁的危险因素(P<0.05),多元线性回归分析显示血清Hcy和hs-CRP水平可影响HAMD评分(P<0.05)。结论血清Hcy和hs-CRP水平升高是永久人工心脏起搏器植入术后患者发生抑郁的危险因素,血清Hcy和hs-CRP水平的高低可作为判断患者抑郁程度的标准。Objective To investigate the relationship between serum Hcy and hs-CRP levels in patients with depression after permanent artificial cardiac pacemaker implantation. Methods Seventy-eight patients who underwent permanent artificial cardiac pacemaker implantation in the Department of Cardiology from January 2015 to February 2018 were enrolled. Three months after the operation, the Hamilton 24 Depression Scale (HAMD) questionnaire was distributed. The HAMD scores >8 or more were included in the depression group, and the HAMD score≤8 was included in the control group. The general data of the two groups were analyzed, and the serum levels of Hcy and hs-CRP were measured. The risk factors of depression in patients after permanent artificial pacemaker implantation were analyzed. Results Of the 78 patients in this study, 26 patients had depression after permanent artificial cardiac pacemaker implantation, and the incidence of depression was 33%. There were no significant differences in gender, age, education, marriage, smoking, diabetes mellitus and hypertension between the two groups (P>0.05). There were significant differences in economic income, combined with more than two diseases, negative life events, and arrhythmia between the two groups (P<0.05). Serum Hcy and hs-CRP levels in the depression group were (31±10)μmol/L and (10.5±1.7) mg/L, respectively, which were significantly higher than those in the control group (13±5)μmol/L,(2.1±1.0) mg/L, respectively;Logistic regression analysis showed that negative life events, arrhythmia, Hcy>15 μmol/L, and hs-CRP>10 mg/L were risk factors for postoperative depression (P<0.05). Multiple linear regression analysis showed that serum Hcy and hs-CRP levels could affect the HAMD score (P<0.05). Conclusion Elevated serum Hcy and hs-CRP levels are risk factors for depression in patients with permanent artificial cardiac pacemaker implantation. Serum Hcy and hs-CRP levels can be used as criteria for determining the degree of depression in patients.

关 键 词：心脏起搏器 人工 同型半胱氨酸 抑郁 高敏C反应蛋白 相关性 

分 类 号：R541.7[医药卫生—心血管疾病] R749.4[医药卫生—内科学]