老年STEMI患者急诊PCI术后抑郁状态及影响因素分析  

Depression state and its influencing factor analysis in aged STEMI patients after emergency PCI

作　　者：周琦 夏林虎[1] 江荣炎[1] ZHOU Qi;XIA Lin-hu;JIANG Rong-yan(Interventional Catheter Room,People’s Hospital of Bozhou City,Bozhou,Anhui,236000,China)

机构地区：[1]亳州市人民医院介入导管室,安徽亳州236000

出　　处：《心血管康复医学杂志》2022年第2期179-183,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨老年急性ST段抬高型心肌梗死(STEMI)患者在急诊经皮冠状动脉介入治疗(PCI)术后抑郁发生情况并分析其影响因素。方法:回顾性选择2019年7月至2021年7月在我院心内科急诊行PCI治疗的240例老年STEMI患者为研究对象,出院前一天采用汉密尔顿抑郁(HAMD)量表评估其抑郁状态。根据是否出现抑郁,患者被分为抑郁组(56例)和无抑郁组(184例),比较两组患者的临床资料,分析抑郁发生的影响因素以及年龄与抑郁的相关性。结果:单因素分析显示女性、文化程度低、丧偶或离异、高脂血症、糖尿病、人体质量指数(BMI)≥28kg/m^(2)、中风病史以及植入支架数量≥3枚的老年STEMI患者抑郁症的发生率显著升高(P<0.05或<0.01)。多因素Logistic回归分析显示女性、文化程度低、丧偶或离异、糖尿病、植入支架数目≥3枚是老年STEMI患者急诊PCI术后抑郁的独立危险因素(OR=1.674~6.276,P<0.05或<0.01)。Pearson相关分析显示,年龄与HAMD得分呈显著正相关(r=0.767,P=0.001)。结论:老年STEMI患者急诊PCI术后抑郁的发生率较高,女性、文化程度较低、丧偶或离异、糖尿病以及植入过多的支架等是发生抑郁的独立危险因素;随着年龄增长,抑郁会加重,对危险因素进行积极干预,可改善预后,有重要意义。Objective:To explore incidence of depression in aged patients with acute ST segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI)and analyze its influencing factors.Methods:A total of 240 aged STEMI patients after emergency PCI in our cardiology department from Jul 2019 to Jul 2021 were selected.All patients were assessed by Hamilton rating scale for depression(HAMD)for depression state on last day before discharge.According to depression or not,patients were divided into depression group(n=56)and no depression group(n=184).Clinical data were compared between two groups.Influencing factors for depression and correlation between age and depression state were analyzed.Results:Single factor analysis indicated that incidence rate of depression significantly rose in aged STEMI patients with female,low education level,widowed or divorced,hyperlipidemia,diabetes mellitus(DM),body mass index(BMI)≥28kg/m^(2),stroke history and number of implanted stents≥3,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that female,low education level,widowed or divorced,DM and number of implanted stents≥3 were independent risk factors for depression in aged STEMI patients after emergency PCI(OR=1.674~6.276,P<0.05 or<0.01).Pearson correlation analysis indicated that age was significant positively correlated with HAMD score(r=0.767,P=0.001).Conclusion:Incidence rate of depression is high in aged STEMI patients after emergency PCI.Female,low education level,widowed or divorced,DM and too many implanted stents etc.can independently affect depression occurrence.Depression state aggravates along with aging.Active intervention on related influencing factors possesses important significance for improve patient′s prognosis.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 抑郁 

分 类 号：R542.220.9[医药卫生—心血管疾病]