社区老年慢性心力衰竭患者焦虑抑郁现状的流行病学研究  

Epidemiologic study on the current situation of anxiety and depression in community elderly patients with chronic heart failure

作　　者：郝佳佳 丘惠嫦[1] 周沛萱 谢海群[2] HAO Jiajia;QIU Huichang;ZHOU Peixuan(The First People’s Hospital of Guangzhou City,Guangdong,Guangzhou 510180,China)

机构地区：[1]广东省广州市第一人民医院,510180 [2]广东省佛山市第一人民医院

出　　处：《河北医药》2023年第1期136-138,共3页Hebei Medical Journal

基　　金：佛山市自筹经费类科技计划项目(编号:1920001001161)。

摘　　要：目的研究社区老年慢性心力衰竭患者焦虑抑郁情绪,找出焦虑抑郁情绪严重程度和患者病情严重程度的关系,提出有效的情绪管理方案。方法纳入老年慢性心力衰竭患者450例,均为2019年5月至2021年5月广州市越秀区某社区接受家庭医生签约服务人群,将其组建为观察组,另外将同一时间在该社区体检的65岁≥健康老年人450例组建为对照组,焦虑抑郁情绪采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)。分析2组抑郁率、焦虑率及程度,并分析患者的HAMD、HAMA评分结构,找出患者在情绪方面的特征,分析患者病情指标、对疾病认识水平和HAMD评分、HAMA评分的关联关系。结果观察组焦虑率、抑郁率高于对照组(P<0.05);受试者HAMA评分特点上,对照组躯体性焦虑因子评分较高(P<0.01),观察组精神性焦虑因子评分较低(P<0.05);受试者HAMD评分特点上,观察组焦虑躯体化、阻滞、睡眠障碍、全身症状因子分数较高(P<0.05),2组体重、认知障碍差异无统计学意义(P>0.05)。老年慢性心力衰竭患者HAMD评分、HAMA评分和患者NYHA心功能分级之间有一定关联性,和患者6 min步行试验及患者对慢性心力衰竭疾病相关知识的认知水平存在关联关系,体现出负相关性。结论心力衰竭患者身体感受以及心力衰竭病情严重程度会影响患者情绪,为有效预防,首先要改善患者的不良感受,进行有效的心理疏导,才能确保患者积极面对疾病。Objective To investigate the current situation of anxiety and depression in community elderly patients with chronic heart failure, and explore the correlation between the severity of anxiety, depression and the severity of the disease, so as to put forward an effective emotion management program.Methods A total of 450 elderly patients with chronic heart failure who received diagnosis and treatment in our hospital from January 2017 to January 2021 were enrolled as observation group, at the same time, the other 450 healthy elderly patients who underwent health examination were enrolled as control group. HAMD rating scale and HAMA rating scale were used to evaluate the anxiety and depression emotions, and the depression rate, anxiety rate and degree were observed and compared between the two groups.Moreover the HAMD and HAMA score structure was analyzed to find out the characteristics of the patients in terms of emotions. In addition the correlation among the disease indicators, the level of disease awareness and the HAMD score as well as HAMA score was analyzed.Results The anxiety rate and depression rate in observation group were significantly higher than those in control group(P<0.05),however, the somatic anxiety factor scores of HAMA scoring characteristics and mental anxiety factor scores in control group were significantly higher than those in observation group(P<0.01).The scores of somatization, block, sleep disorder and systemic symptom factors of anxiety in terms of HAMD score in observation group were significantly higher than those in control group(P<0.05).However there were no significant differences in body weight and cognitive impairment between the two groups(P>0.05).In addition there was a certain correlation between HAMD score, HAMA score and NYHA cardiac function grade in elderly patients with chronic heart failure, and there was a negative correlation between between HAMD score, HAMA score and 6-min walking test as well as patients’ cognitive level about the knowledge related to chronic heart fa

关 键 词：老年慢性心力衰竭 焦虑 抑郁 

分 类 号：R749.72[医药卫生—神经病学与精神病学]