冠心病伴抑郁患者视网膜神经血管特征及其与抑郁严重程度的相关性  

Retinal neurovascular characteristics and their correlation with depression severity in patients with coronary artery disease and depression

作　　者：何雪 马欢 李聪 王艳[1,2] 况宇 刘磊[2] 余洪华 杨小红[1,2] HE Xue;MA Huan;LI Cong;WANG Yan;KUANG Yu;LIU Lei;YU Hong-hua;YANG Xiaohong(School of Medicine,South China University of Technology,Guangzhou 510006,Guangdong,China;Guangdong Eye Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,Guangdong,China;不详)

机构地区：[1]华南理工大学医学院,广东广州510006 [2]南方医科大学附属广东省人民医院(广东省医学科学院)广东省眼病防治研究所,广东广州510080 [3]南方医科大学附属广东省人民医院(广东省医学科学院)广东省心血管疾病研究所,广东广州510080

出　　处：《实用医学杂志》2025年第4期515-521,共7页The Journal of Practical Medicine

基　　金：国家自然科学基金面上项目(编号:82271125)。

摘　　要：目的评估冠心病伴抑郁障碍患者(CADD)的视网膜神经血管变化及其与抑郁严重程度的关联。方法本研究共纳入40例CADD患者、56例冠心病不伴抑郁障碍患者(CADND)和31例健康对照组。通过光学相干断层扫描血管成像技术(OCTA)量化视网膜黄斑区浅层血管密度(SCP)、深层血管密度(DCP)、神经纤维层厚度(RNFL)及神经节细胞(GCC)等,分析组间差异及其与PHQ-9评分的关联。结果与健康人群相比,CADD和CADND患者SCP和DCP均显著下降(P<0.05);与CADND患者相比,CADD患者RNFL上半部分厚度和GCC厚度(包括总体平均厚度、上半部分和下半部分GCC厚度)均显著增加(P<0.05)。PHQ-9评分与RNFL平均厚度下半部分区域厚度呈负相关(P<0.05)。结论CADD患者视网膜血管神经结构均发生特征性改变,且神经层改变与患者的抑郁严重程度密切相关。Objective To evaluate retinal vascular and neural changes in patients with coronary artery disease with depression(CADD)and to investigate their association with depression severity.Methods A total of 40 patients with CADD,56 patients with CAD without depressive disorder(CADND),and 31 healthy controls were included in this study.The vessel density of superficial capillary plexus(SCP)and deep capillary plexus(DCP),and the thickness of the retinal nerve fiber layer(RNFL)and ganglion cell complex(GCC),were quanti⁃fied using optical coherence tomography angiography(OCTA)to analyze the differences between the groups and their correlation with PHQ-9 scores.Results Compared with the healthy control group,SCP and DCP were signifi⁃cantly decreased in both CADD and CADND groups(P<0.05).Both superior hemi in RNFL thickness and GCC thickness(including mean,superior hemi,and inferior hemi)were significantly increased in patients with CADD compared with patients with CADND(P<0.05).PHQ-9 scores were negatively correlated with the mean and infe⁃rior RNFL thickness(P<0.05).Conclusion Both retinal vascular neural structures were altered in patients with CADD,and the neural alterations were strongly correlated with the severity of the patient′s depression symptom.

关 键 词：冠心病 抑郁障碍 光学相干断层扫描血管成像 

分 类 号：R771.3[医药卫生—眼科]