老年慢性心衰患者抑郁焦虑状态与血清炎症标志物的相关性  

Associations of depression and anxiety statues with serum inflammatory biomarkers in elderly patients with chronic heart failure

作　　者：李雯曦 刘国顺[2] 彭程[1] 楼慧玲[1] Li Wenxi;Liu Guoshun;Peng Cheng;Lou Huiling(Department of Geriatrics,Guangzhou First People's Hospital,Guangzhou 510180,China;Department of Radiology,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院老年病科,510180 [2]广州市第一人民医院放射科,510180

出　　处：《中华神经医学杂志》2020年第12期1228-1234,共7页Chinese Journal of Neuromedicine

基　　金：广东省医学科学技术研究基金(A2019005);广州市科技计划项目(201903010091).

摘　　要：目的评估老年慢性心衰患者抑郁焦虑状态与其血清炎症标志物水平的相关性。方法选择广州市第一人民医院老年病科自2018年1月至2020年1月收治的225例老年慢性心衰患者为研究对象,分别采用Zung抑郁自评量表(SDS)和Zung焦虑自评量表(SAS)明确患者是否存在抑郁、焦虑状态并评估其程度。比较对照组(无抑郁和焦虑)、抑郁组、焦虑组、抑郁焦虑组(同时有抑郁和焦虑)患者间人口学及临床资料、老年综合评估指标、血清炎症标志物水平的差异。采用Spearman相关性检验分析抑郁、焦虑患者血清炎症标志物水平与抑郁、焦虑程度的相关性,二分类Logistic回归分析确定患者抑郁、焦虑状态的独立影响因素。结果(1)与对照组比较,抑郁组、焦虑组及抑郁焦虑组患者的Tiburg衰弱量表评分增加、简易智力状态检查量表(MMSE)评分降低、明尼苏达心衰生存质量量表(MLWHFQ)评分增加、合并2~4种疾病和服用2~4种药物者所占比例增高、基本生活活动能力(BADL)评分降低,差异均有统计学意义(P<0.05);与抑郁组和焦虑组比较,抑郁焦虑组患者上述指标的变化更明显,差异均有统计学意义(P<0.05)。与对照组比较,抑郁组、焦虑组、抑郁焦虑组患者的血清白细胞介素(IL)-6、C反应蛋白(CRP)水平升高,焦虑组、抑郁焦虑组患者的血清同型半胱氨酸(Hcy)水平升高,抑郁组、抑郁焦虑组患者的血清肿瘤坏死因子α(TNF-α)水平升高,差异均有统计学意义(P<0.05)。抑郁焦虑组患者的血清CRP、Hcy、TNF-α水平高于抑郁组,血清IL-6、CRP、Hcy及TNF-α水平高于焦虑组,差异均有统计学意义(P<0.05)。与对照组比较,抑郁焦虑组患者有营养不良风险者所占比例增高,差异有统计学意义(P<0.05)。(2)抑郁患者血清IL-6、CRP及TNF-α水平与抑郁程度均呈正相关关系(P<0.05),焦虑患者血清IL-6、CRP及Hcy水平与焦虑程度均呈正相关关系(P<0.05)。Objective To evaluate the associations of depression and anxiety statues with serum inflammatory biomarkers in elderly patients with chronic heart failure.Methods From January 2018 to January 2020,225 elderly patients with chronic heart failure were enrolled from our hospital.Zung Self-Rating Depression Scale(SDS)and Zung Self-Rating Anxiety Scale(SAS)were performed in all patients to determine if the patients were with depression and anxiety statues and evaluate the degrees of depression and anxiety.The differences in demographic and clinical data,geriatric comprehensive assessment indicators,and serum inflammatory markers were compared among patients in the control group(without depression and anxiety),depression group,anxiety group,and depression and anxiety group(with both depression and anxiety).Spearman correlation test was used to analyze the correlation between the levels of serum inflammatory markers and the degrees of depression and anxiety in patients with depression and anxiety.Binary Logistic regression analysis was used to determine the independent influencing factors for depression and anxiety.Results(1)As compared with those in the control group,patients in the depression group,anxiety group,and depression and anxiety group had significantly increased scores of Chinese version of Tilburg Frailty Indicator,statistically decreased Mini Mental State Examination(MMSE)scores,significantly increased Minnesota Living with Heart Failure Questionnaire(MLWHFQ)scores,increased proportions of patients with 2-4 kinds of diseases and those taking 2-4 kinds of drugs,and decreased Basic Activity of Daily Living(BADL)scores(P<0.05);as compared with those in the depression group and the anxiety group,the changes of the above indicators in the depression and anxiety group were more obvious with significant differences(P<0.05).As compared with those in the control group,patients in the depression group,anxiety group,and depression and anxiety group had significantly increased serum interleukin(IL)-6 and C-reactive pr

关 键 词：老年慢性心衰 抑郁 焦虑 炎症标志物 

分 类 号：R541.6[医药卫生—心血管疾病] R749[医药卫生—内科学]