住院冠心病患者焦虑/抑郁状态及其影响因素分析  

Analysis of Anxiety/Depression Status and Its Influencing Factors in Hospitalized Patients with Coronary Heart Disease

作　　者：马福清 付美娇 何军[3] MA Fuqing;FU Meijiao;HE Jun(Department of Cardiology,The Fifth People’s Hospital of Ningxia,Yinchuan 753000,China;Health Department,Yantai Yuhuangding Hosipital,Yantai 264000,China;Department of Cardiology,General Hospital of Ningxia Medical University,The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏第五人民医院心血管内科,石嘴山753000 [2]烟台毓璜顶医院保健科,烟台264000 [3]宁夏医科大学总医院心血管内科,宁夏医科大学第一临床医学院,银川750004

出　　处：《宁夏医科大学学报》2024年第8期819-823,835,共6页Journal of Ningxia Medical University

基　　金：宁夏回族自治区重点研发计划项目(2021BEG03115)。

摘　　要：目的探讨住院冠心病(CHD)患者焦虑/抑郁状态的发生率及影响因素,提升CHD的临床综合管理水平。方法采用包含患者年龄、性别、体质量、既往史、个人史、睡眠质量、经济状况、受教育程度、精神紧张程度等指标的自制量表以及汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD),对住院CHD患者进行心理测评,总结患者的临床资料特点,分析CHD患者焦虑/抑郁状态的发生率及其影响因素。结果本研究共纳入CHD患者215例,其中男性138例(64.19%)、女性77例(35.81%),平均年龄(61.77±10.37)岁,其中老年患者(≥65岁)92例(42.79%)。焦虑、抑郁及焦虑合并抑郁状态的发生率分别为43.26%、33.49%和26.05%,女性的发生率均高于男性(63.6%vs 31.9%,51.9%vs 23.2%,45.5%vs 15.2%,P均<0.05)。二元Logistic回归分析及受试者工作特征(ROC)曲线显示,HAMD评分≥5.5分是焦虑状态的独立危险因素,经济状况差、HAMA评分≥8.5分是抑郁状态的独立危险因素,经常失眠、精神紧张是焦虑合并抑郁状态的独立危险因素。HAMD评分为5.5分预测焦虑状态的灵敏度和特异度分别为75.27%和77.87%,约登指数为0.531;HAMA评分为8.5分预测抑郁状态的灵敏度和特异度分别为73.61%和83.22%,约登指数为0.568。结论焦虑、抑郁及焦虑合并抑郁状态较普遍存在于住院CHD患者中。其中,严重失眠、精神紧张及低收入与CHD患者发生焦虑、抑郁有关。HAMD评分、HAMA评分可预测CHD患者焦虑、抑郁状态。Objective To investigate the incidence and influencing factors of anxiety/depression of in-hospitalized patients with coronary heart disease(CHD)and to improve the comprehensive management of CHD.Methods A self-designed scale including age,gender,disease history,sleep quality,and mental stress,etc,together with the Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)were used to assessment the psychological status of the enrolled subjects.The characteristics of the subjects were recorded.The incidence and influencing factors of anxiety/depression in CHD patients were analyzed.Results A total of 215 CHD patients including 138 males(64.19%)and 77 females(35.81%)were included.The age was(61.77±10.37)years old.And 92 of them(42.79%)were elderly people(≥65 years old).The incidence of anxiety,depression,and anxiety combined with depression was 43.26%,33.49%and 26.05%respectively.The incidences in the females were higher than those of the male(63.6%vs 31.9%,51.9%vs 23.2%,45.5%vs 15.2%,P all<0.05).Multivariate Logistic regression and ROC curve analysis indicated that HAMD score≥5.5 was the independent risk factor of anxiety,low income and HAMA score≥8.5 were the independent risk factors of depression,frequent insomnia and severe nervousness were the independent risk factors of anxiety with depression status.The sensitivity and the specificity of HAMD score of 5.5 in predicting anxiety was 75.27%,and 77.87%respectively,with a Youden index of 0.531.The sensitivity and specificity of HAMA score of 8.5 in predicting depression was 73.61%and 83.22%respectively,the Youden index was 0.568.Conclusion Anxiety and depression are popular in in-hospitalized CHD patients.Severe insomnia,nervousness,and low income are related to these mental disorders.HAMD score and HAMA score are of high value in predicting anxiety and depression in CHD patients.

关 键 词：冠心病 焦虑状态 抑郁状态 危险因素 

分 类 号：R473.5[医药卫生—护理学]