住院老年心力衰竭患者抑郁障碍患病状况及影响因素初步分析  

Prevalence of depressive disorder in hospitalized elderly patients with heart failure and preliminary analysis of the associated factors

作　　者：梁玉兰 吕晓珍[1] 张莹[1] 贺建华 吕强[3] 王华丽[1] LIANG Yulan;LV Xiaozhen;ZHANG Ying;HE Jianhua;LV Qiang;WANG Huali(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health ( Peking University) ,National Clinical Research Center for Mental Disorders ( Peking University Sixth Hospital) ,Beijing 100191,China)

机构地区：[1]北京大学第六医院北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学)国家精神心理疾病临床医学研究中心(北京大学第六医院)临床研究室,100191 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所精神心理科 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科

出　　处：《心肺血管病杂志》2019年第5期476-479,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都卫生发展科研专项项目(首发2016-1-4117)

摘　　要：目的:调查住院老年心力衰竭患者抑郁障碍的患病比例,并探索其相关影响因素。方法:使用自编问卷收集122例住院老年心力衰竭患者的人口学资料、疾病信息、实验室检查结果及常用药物的使用情况,由专业精神科医师采用抑郁障碍诊断工具-中文版简明国际神经精神访谈(M.I.N.I.)对所有受试者进行诊断性访谈,确定是否患有抑郁障碍及其亚型,采用Logistic回归分析心力衰竭共患抑郁障碍的相关影响因素。结果:40.2%(49/122)的住院老年心力衰竭患者患有抑郁障碍,其中重性抑郁障碍患病比例为22.1%,轻性抑郁障碍17.3%,心境恶劣障碍0.8%。多因素分析显示,纽约心功能(NYHA)分级越高(心功能越差),共患抑郁障碍的风险越高(OR=2.341,95%CI:1.167~4.696,P=0.017),使用肾素-血管紧张素系统(RAS)抑制剂(OR=0.377,95%CI:0.156~0.912,P=0.031)与抑郁障碍患病风险较低相关联。结论:住院老年心力衰竭患者抑郁障碍患病比例较高,心功能差是共患抑郁障碍的危险因素,使用RAS抑制剂有可能降低抑郁障碍的患病风险,但需进一步深入研究。Objective:The study aims to investigate the prevalence of the depressive disorder in hospitalized elderly patients with heart failure and to explore the potential factors associated with the comorbid depressive disorder.Methods:One hundred and twenty-two elderly inpatients with heart failure were recruited.The demographic data,disease information,laboratory test result and drug usage were collected by the self-developed questionnaire.All participants were interviewed with the Chinese version Mini-International Neuro-psychiatric Interview(M.I.N.I.)by a professional psychiatrist.A diagnosis of depressive disorder and its subtypes were made based on the diagnostic interview.Logistic regression was used to examine the factors associated with the presence of depressive disorder.Results:40.2%(49/122)of study participants met the criteria of all types of depressive disorder,including major depressive disorder(22.1%),minor depressive disorder(17.3%),and dysthymia disorder(0.8%).Logistic regression found that the higher New York Heart Association(NYHA)classification(poorer cardiac function)was associated with the higher risk of depressive disorder(OR=2.341,95%CI:1.167-4.696,P=0.017).The use of renin-angiotensin system(RAS)inhibitors(OR=0.377,95%CI:0.156-0.912,P=0.031)was associated with the lower risk of depressive disorder.Conclusions:Depressive disorder is prevalent among hospitalized elderly patients with heart failure.Poorer cardiac function may be a risk factor of depressive disorder and the use of RAS inhibitors might reduce the risk.Further studies are warranted.

关 键 词：心力衰竭 抑郁障碍 患病率 影响因素 老年 

分 类 号：R54[医药卫生—心血管疾病]