急性心肌梗死患者PCI术后抑郁发生与应激激素水平的相关性分析  

Correlation analysis of stress hormone levels and depression occurrence in patients with acute myocardial infarction after PCI

作　　者：王会春 付刚 刘艳玲 贺俊波 李黎 孙彬彬 WANG Huichun;FU Gang;LIU Yanling;HE Junbo;LI Li;SUN Binbin(Department of Cardiology,Shenzhen Longgang District Third People's Hospital,Shenzhen 518112,Guangdong,China;Shenzhen People's Hospital,Shenzhen 518115,Guangdong,China)

机构地区：[1]深圳市龙岗区第三人民医院心内科,广东深圳518112 [2]深圳市人民医院,广东深圳518115

出　　处：《中南医学科学杂志》2023年第6期949-952,共4页Medical Science Journal of Central South China

基　　金：深圳市龙岗区2020年度医疗卫生科技计划项目(LGKCYLWS2020180)。

摘　　要：目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)术后的应激激素水平与抑郁发生的相关性。方法选取接受PCI手术的180例AMI患者,采用汉密尔顿抑郁量表(HAMD)评估患者是否存在抑郁状态。采用Logistic回归模型分析影响AMI患者PCI术后抑郁的危险因素,采用Pearson相关性分析去甲肾上腺素(NE)、皮质醇(Cor)、醛固酮(Ald)和多巴胺(DA)水平与抑郁的相关性。结果180例AMI患者PCI术后HAMD评分为(20.14±7.83)分,AMI患者PCI术后抑郁率为40.56%。有、无抑郁者年龄、婚姻、家庭月收入、医保类型、GRACE评分、住院天数、NE、Cor、Ald和DA水平比较差异有显著性(P<0.05)。年龄≥60岁、自费、NE、Cor、Ald和DA水平是影响AMI患者PCI术后抑郁的危险因素(P<0.05)。重度抑郁组患者NE、Cor、Ald和DA水平高于轻度抑郁和中度抑郁组,中度抑郁组高于轻度抑郁组(P<0.05)。NE、Cor、Ald和DA与HAMD评分呈正相关关系(P<0.001)。结论年龄、医保类型、NE、Cor、Ald和DA水平是影响AMI患者PCI术后抑郁的独立危险因素,临床应对危险因素进行医学干预,避免抑郁状态对患者的影响。Aim To analyze the incidence of depression and its relationship with stress hormones in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 180 AMI patients undergoing PCI were selected.The Hamilton depression rating scale(HAMD)was used to assess whether the patients had depressive state.Logistic regression model was used to analyze the risk factors for depression in patients with AMI after PCI,and Pearson correlation was used to analyze the correlation between levels of norepinephrine(NE),cortisol(Cor),aldosterone(Ald)and dopamine(DA)and depression.Results The HAMD score of 180 AMI patients after PCI was(20.14±7.83),and the depression rate of AMI patients after PCI was 40.56%.There are significant differences in age,marriage,family monthly income,health insurance type,GRACE score,hospital stay,and NE,Cor,Ald,and DA levels between individuals without depression(P<0.05).Age≥60 years,self-pay,NE,Cor,Ald and DA levels were the risk factors of post-PCI depression in AMI patients(P<0.05).The levels of NE,Cor,Ald and DA in the severe depression group were higher than those in the mild and moderate depression groups,and the moderate depression group were higher than those in the mild depression group(P<0.05).HAMD scores positively correlated with NE,Cor,Ald,and DA(P<0.001).Conclusion Age,type of health insurance,NE,Cor,Ald and DA levels are the independent risk factors for depression in patients with AMI after PCI.In order to avoid the influences of depressive state on patients,medical intervention should be performed on risk factors in clinical practice.

关 键 词：急性心肌梗死 PCI 抑郁 应激激素 相关性分析 

分 类 号：R542.22[医药卫生—心血管疾病]