原发性微血管心绞痛患者抑郁状态与血管内皮功能的关系研究  

Study on the correlation between depressive state and vascular endothelial function in patients with primary microvascular angina

作　　者：黄琪[1] 隋向前[1] 王敏[1] 王士生[1] 蒋凤春[1] 金信垚 朱秋静 HUANG Qi;SUI Xiangqian;WANG Min;WANG Shisheng;JIANG Fengchun;JIN Xinyao;ZHU Qiujing(Department of Cardiovascular Medicine,Hangzhou Red Cross Hospital,Hangzhou 310003,China;Department of General Medicine,Hospital of Traditional Chinese Medicine in Xiacheng District of Hangzhou City,Hangzhou 310003,China)

机构地区：[1]杭州市红十字会医院心血管内科,浙江杭州310003 [2]杭州市下城区中医院全科医学科,浙江杭州310003

出　　处：《中国现代医生》2022年第5期17-21,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY510,2020KY220);浙江省中医药科技计划项目(2020ZA083)。

摘　　要：目的测定原发性微血管心绞痛(PMVA)患者血浆血管性假血友病因子(v WF)及同型半胱氨酸(Hcy)的水平来评估血管内皮功能,分析PMVA患者血管内皮功能与其抑郁状态评分的关系。方法选择2019年1月至2020年12月在杭州市红十字会医院心血管内科检查诊断为PMVA的患者65例(PMVA组),正常体检人群42名作为正常对照组,测定其血浆v WF、Hcy及超敏C-反应蛋白水平;记录所有研究者的贝克抑郁自评量表及汉密尔顿抑郁自评量表评分数值。结果PMVA患者v WF水平[(72.591±33.102)m IU/ml]及超敏C-反应蛋白水平[(3.053±1.856 mg/L)]与正常对照组的v WF水平[(23.765±3.983)m IU/ml]及超敏C-反应蛋白水平[(0.712±0.546)mg/L]比较,均显著升高,差异有统计学意义(P<0.001);PMVA患者Hcy水平[(12.522±7.371)μmol/L]与正常对照组的Hcy水平[(12.845±1.937)μmol/L]比较,差异无统计学意义(P>0.05);PMVA患者贝克抑郁自评量表评分值为(15.920±5.901)分,较正常对照组的贝克抑郁自评量表评分值(5.190±1.509)分显著升高,差异有统计学意义(P<0.001);PMVA患者汉密尔顿抑郁自评量表评分值为(22.090±7.705)分,较正常对照组的贝克抑郁自评量表评分值(9.240±2.864)分显著升高,差异有统计学意义(P<0.001);所有入选研究者的v WF及超敏C-反应蛋白水平与贝克抑郁自评量表及汉密尔顿抑郁自评量表评分值均呈正相关(P<0.001);所有研究者的Hcy水平与贝克抑郁自评量表及汉密尔顿抑郁自评量表的评分值均无相关性(P>0.05)。结论PMVA患者较正常体检人群存在内皮功能受损及显著的抑郁状态,所有研究者的v WF及超敏C-反应蛋白水平均与贝克及汉密尔顿抑郁自评量表评分值正相关。Objective To determine the plasma levels of von Willebrand factor(v WF)and homocysteine(Hcy)in patients with primary microvascular angina(PMVA)to assess vascular endothelial function and analyze the correlation between vascular endothelial function and depressive state scores in PMVA patients.Methods A total of 65 patients diagnosed with PMVA by examination from January 2019 to December 2020 to Department of Cardiovascular Medicine,Hangzhou Red Cross Hospital were selected as PMVA group,and 42 participants with normal physical examination were selected as normal controls.The plasma v WF,Hcy and hypersensitive C-reactive protein(hs-CRP)levels of all the participants were measured,and the scores of beck depression inventory(BDI)and hamilton depression scale(HAMD)of all participants were recorded.Results The v WF level([72.591±33.102]m IU/ml)and hs-CRP level([3.053±1.856]mg/L)of PMVA patients were significantly higher than those of normal controls([23.765±3.983]m IU/ml)and([0.712±0.546]mg/L),respectively,with statistically significant differences(P<0.001).There was no statistically significant difference in the Hcy level between PMVA patients([12.522±7.371]μmol/L)and normal controls([12.845±1.937]μmol/L)(P>0.05).The BDI score of PMVA patients([15.920±5.901]points)was significantly higher than that ofnormal controls([5.190±1.509]points),with statistically significant difference(P<0.01).The HAMD score of PMVA patients([22.090±7.705]points)was significantly higher than that of normal controls([9.240±2.864]points),with statistically significant difference(P<0.001).The v WF and hs-CRP levels were positively correlated with the BDI score and the HAMD score in all the participants(P<0.001),while there was no correlation between the Hcy level and the BDI score and the HAMD score in all the participants(P>0.05).Conclusion PMVA patients have impaired endothelial function as well as a significant depressive state compared to the population with normal physical examination.The v WF and hsCRP levels are positively co

关 键 词：原发性微血管心绞痛 抑郁状态 血管内皮功能 血管性假血友病因子 同型半胱氨酸 超敏C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]