老年冠心病合并焦虑患者的血管内皮功能及预后观察  

Vascular endothelial function and prognosis in elderly patients with coronary heart disease and anxiety

作　　者：王朝清[1] 高晓磊[1] 焦全德[1] 任明芬[1] 袁磊[2] WANG Chaoqing;GAO Xiaolei;JIAO Quande(epartment of Cardiology,the Second Affiliated Hospital of Xinxiang Medical Unoversity,Xinxiang 453002,China)

机构地区：[1]新乡医学院第二附属医院/新乡市心脏心理健康研究重点实验室心血管内科,新乡453002 [2]新乡医学院

出　　处：《国际精神病学杂志》2021年第2期275-278,共4页Journal Of International Psychiatry

摘　　要：目的探讨老年冠心病合并焦虑患者的血管内皮功能表达情况及其对预后的影响。方法选取2017年8月~2020年8月期间我院接受治疗的老年冠心病患者80例作为研究对象。按焦虑自评量表(SAS)评分结果将研究对象分为焦虑组(n=45)和非焦虑组(n=35),同时将焦虑组分为轻度焦虑组(n=21)、中度焦虑组(n=13)、重度焦虑组(n=11)三个亚组;观察比较四组内皮功能评估指数(RHI)、内皮祖细胞(EPCs)、内皮素-1(ET-1)、肌酸激酶同工酶(CK-MB)、天冬氨酸转氨酶(AST)、超敏C反应蛋白(hs-CRP)水平、细胞间黏附因子-1(CAM-1)水平,分析焦虑组患者的SAS评分与上述有差异指标的相关性;另对患者的预后情况进行随访观察,比较患者1年内不良心血管事件发生情况。结果 (1)中、重度焦虑组患者的RHI和EPCs水平低于非焦虑组及轻度焦虑组,ET-1水平高于非焦虑组及轻度焦虑组(P<0.05)。(2)中、重度组患者的CK-MB、hs-CRP和CAM-1水平高于非焦虑组及轻度焦虑组,重度组患者的CAM-1水平高于中度焦虑组(P<0.05)。(3)经Pearson相关性分析显示,SAS评分与RHI和EPCs水平呈负相关,与ET-1、CK-MB、hsCRP、CAM-1水平呈正相关(P<0.05)。(4)随访1年结果显示,焦虑组患者非致死性心肌梗死和脑卒中发生率明显高于非焦虑组(P<0.05)。结论焦虑症可能通过影响老年冠心病患者的血管内皮功能及心肌酶表达来改变疾病进展,且其预后不良事件风险更高。Objective To investigate the expression of vascular endothelial function and its influence on prognosis in elderly patients with coronary heart disease and anxiety. Methods A total of 80 elderly patients with coronary heart disease treated in our hospital from August 2017 to August 2020 were selected as the research objects. According to the results of self-rating anxiety scale(SAS),the subjects were divided into the anxiety group(n=45)and the nonanxiety group(n=35),and the anxiety group was divided into three subgroups :the mild anxiety group(n=21),the moderate anxiety group(n=13)and the severe anxiety group(n=11). Reactive hyperemia index(RHI),endothelial progenitor cells(EPCs),endothelin1(ET 1),creatine kinase isoenzyme(CK-MB),aspartate aminotransferase(AST),hypersensitive c-reactive protein(hs CRP) levels,intercellular adhesion factor-1-1(CAM)level among four groups were compared. The correlation between SAS score and the above indicators was analyzed In addition,the prognosis of the patients was followed up to compare the incidence of adverse cardiovascular events in the patients within 1 year. Results (1)The levels of RHI and EPCs in patients with moderate and severe anxiety were lower than those in the non-anxiety group and the mild anxiety group,and the levels of ET-1 were higher than those in the non-anxiety group and the mild anxiety group(P<0.05).(2)The levels of CK-MB,HS-CRP and CAM-1 in the moderate and severe groups were higher than those in the non-anxiety group and the mild anxiety group,and the levels of CAM-1 in the severe group were higher than those in the moderate anxiety group(P< 0.05).(3)Pearson correlation analysis showed that SAS score was negatively correlated with RHI and EPCs levels,and positively correlated with ET-1,CKMB,HS-CRP and CAM-1 levels(P< 0.05).(4)The 1-year follow-up showed that the incidence of non-fatal myocardial infarction and stroke in the anxiety group was significantly higher than that in the non-anxiety group(P< 0.05). Conclusion Anxiety disorders may alter disease

关 键 词：冠心病 焦虑症 老年 血管内皮功能 心肌酶 

分 类 号：R749.99[医药卫生—神经病学与精神病学]