负性情绪与老年急性冠状动脉综合征患者介入术后主要心脏事件发生的相关因素分析  

Correlation between negative emotions and major adverse cardiac event occurrence in elderly patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：孙淑红 王芳 尹向宇 管龙韬 任月 SUN Shuhong;WANG Fang;YIN Xiangyu;GUAN Longtao;REN Yue(Department of Cardiology,Beijing Electric Power Hospital of State Grid Corporation,Beijing 100073,China)

机构地区：[1]国家电网公司北京电力医院心内科,100073

出　　处：《心肺血管病杂志》2024年第6期571-575,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:分析负性情绪与老年急性冠状动脉综合征(acute coronary syndrome,ACS)患者PCI术后主要心脏事件(major adverse cardiac event,MACE)发生的相关性。方法:回顾性分析我院162例行PCI治疗的老年ACS患者临床资料,记录PCI术后12个月MACE发生情况,据此分为MACE组及非MACE组。比较两组基线资料及术后1个月、12个月抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)、Mishel疾病不确定感量表(mishel uncertainty inillness scale,MUIS)、自杀意念量表(suicide ideation scale,SIS)评分差异,并使用受试者工作曲线(ROC曲线)评估PCI术后1个月SDS、SAS、MUIS、SIS评分对MACE发生情况的预测价值。结果:162例老年ACS患者PCI术后12个月发生MACE 39例(24.1%)(MACE组);未发生MACE 123例(76.0%)(非MACE组);两组性别、年龄、医保类型及合并高血压、糖尿病情况比较,差异均无统计学意义(P>0.05);但MACE组已婚率低于非MACE组(P<0.05)。术后12个月时,非MACE组SDS、SAS、MUIS、SIS评分与组内术后1个月比较,差异均无统计学意义(P>0.05),MACE组评分则均较术后1个月升高(P<0.05);且术后1个月、12个月时,MACE组SDS、SAS、MUIS、SIS评分均高于非MACE组(P<0.05)。经ROC曲线分析,发现PCI术后1个月SDS、SAS、MUIS、SIS评分对MACE均具有较高预测价值(AUC=0.701、0.700、0.839、0.788,P<0.05),且4项联合检测预测价值最高(AUC=0.951,P<0.05)。结论:老年ACS患者PCI术后负性情绪可辅助预测MACE发生情况,严重的负性情绪可增加MACE发生风险,临床应在围术期予以心理干预措施。Objective:To analyze the correlation between negative emotions and occurrence of major adverse cardiac events(MACE)in elderly patients with acute coronary syndrome(ACS)after PCI.Methods:The clinical data of 162 elderly ACS patients who underwent PCI treatment in our hospital were retrospectively analyzed,and the occurrence of MACE was recorded at 12 months after PCI,and the patients were divided into MACE group and non-MACE group.The baseline data and scores of self-rating depression scale(SDS),self-rating anxiety scale(SAS),Mishel’s uncertainty in illness scale(MUIS)and suicide ideation scale(SIS)at 1 month and 12 months after surgery were compared between the two groups.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of scores of SDS,SAS,MUIS,and SIS on MACE occurrence at 1 month after PCI.Results:Among 162 elderly ACS patients,39 cases(24.1%)with MACE at 12 months after PCI were included in MACE group,and 123 cases(75.9%)without MACE were included in non-MACE group.There were no significant differences in the gender,age,medical insurance types and hypertension and diabetes mellitus between the two groups(P>0.05).However,the rate of marriage in MACE group was lower than that in non-MACE group(P<0.05).At 12 months after surgery,there were no statistically significant differences in the scores of SDS,SAS,MUIS,and SIS in non-MACE group compared with those within the group at 1 month after surgery(P>0.05),and the scores in MACE group were increased compared with those at 1 month after surgery(P<0.05).At 1 month and 12 months after surgery,the scores of SDS,SAS,MUIS,and SIS in MACE group were higher than those in non-MACE group(P<0.05).ROC curve analysis showed that the scores of SDS,SAS,MUIS,and SIS at 1 month after PCI had high predictive value on MACE(AUC=0.701,0.700,0.839,0.788,P<0.05),and the combination of the four had the highest predictive value(AUC=0.951,P<0.05).Conclusions:Negative emotions in elderly patients with ACS after PCI can help predict the occurrence of MAC

关 键 词：急性冠状动脉综合征 负性情绪 老年 主要心脏事件 抑郁 焦虑 

分 类 号：R54[医药卫生—心血管疾病]