中国城乡地区居民抑郁与心血管疾病及死亡的关联性分析  

Association between Depression and Cardiovascular Disease and Mortality among Residents in Urban and Rural Areas of China

作　　者：代琦 郎欣月 马海滨[3] 张鹏 赵茜[5] 胡泊[2] DAI Qi;LANG Xinyue;MA Haibin;ZHANG Peng;ZHAO Qian;HU Bo(Department of Adult Cardiac Surgery,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China;National Clinical Research Center for Cardiovascular Diseases,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 102308,China;Xining Center for Disease Control and Prevention,Xining 810007,China;Guanshan Town Health Center,Yanliang District,Xi′an 710089,China;Department of General Practice,West China Hospital,Sichuan University,Chengdu 618099,China)

机构地区：[1]中国医学科学院阜外医院成人心外科,北京100037 [2]中国医学科学院北京协和医学院阜外医院国家心血管疾病临床医学研究中心国家心血管疾病中心医学统计部,北京102308 [3]西宁市疾病预防控制中心,西宁810007 [4]西安市阎良区关山镇卫生院,西安710089 [5]四川大学华西医院全科医学中心,成都618099

出　　处：《中国分子心脏病学杂志》2024年第6期6478-6483,共6页Molecular Cardiology of China

基　　金：中国医学科学院阜外医院国家心血管疾病临床医学研究中心自主课题(NCRC2020002)

摘　　要：目的探究抑郁对中国城乡居民全因死亡和主要心血管疾病的影响。方法本研究采用前瞻性的城乡流行病学(PURE)研究,涵盖了来自12个省份的45个城市和70个农村社区的35~70岁参与者。抑郁的筛查使用改编的简易版复合性国际诊断交谈量表,当参与者出现3种或更多症状时,视为抑郁。Cox回归模型用于分析抑郁与全因死亡和主要心血管疾病之间的关联。结果在42652名参与者中,城市居民20680名,农村居民21972名。城市地区的抑郁患病率(2.5%)高于农村地区(2.2%)。中位随访时间11.9年(9.6,12.6年),共发生2066例死亡和3099例主要心血管疾病。与非抑郁人群相比,抑郁人群的全因死亡(HR=1.40,95%CI:1.09~1.81)和主要心血管疾病(HR=1.31,95%CI:1.04~1.66)的风险增加。对于城市居民,与非抑郁人群相比,抑郁人群全因死亡和主要心血管疾病的风险未呈现明显增加。然而,在农村居民中,抑郁人群全因死亡(HR=1.42,95%CI:1.06~1.91)和主要心血管疾病(HR=1.40,95%CI:1.05~1.85)的风险均显著高于非抑郁人群。结论抑郁会增加全因死亡和主要心血管疾病的风险,尤其对于农村居民。因此,居民们需要增强心理健康的意识,以预防死亡及主要心血管疾病的发生。Objective To investigate the association of depression with all⁃cause mortality and major cardiovascular events among urban and rural residents in China.Methods The Prospective Urban Rural Epidemiology(PURE)⁃China cohort included participants aged 35⁃70 years from 45 urban and 70 rural communities across 12 provinces.Depression was assessed using an adapted Short⁃Form Composite International Diagnostic Interview(CIDI⁃SF),with individuals classified as depressed if they reported three or more depressive symptoms.Associations between depression and outcomes were analyzed using the Cox frailty model,focusing on all⁃cause mortality and major cardiovascular disease.Results Of the 42652 participants analyzed,there were 20680 urban residents and 21972 rural residents.Depression prevalence was slightly higher among urban residents(2.5%)compared to rural residents(2.2%).Over a median follow⁃up of 11.9 years(interquartile range 9.6⁃12.6 years),there were 2066 deaths and 3099 major cardiovascular events.Depression significantly increased the risk of all⁃cause mortality(HR=1.40,95%CI:1.09⁃1.81)and major cardiovascular diseases(HR=1.31,95%CI:1.04⁃1.66).Subgroup analyses revealed no significant associations between depression and outcomes in urban residents.However,among rural residents,depression was associated with elevated risks of all⁃cause mortality(HR=1.42,95%CI:1.06⁃1.91)and major cardiovascular diseases(HR=1.40,95%CI:1.05⁃1.85).Conclusion Depression is associated with an increased risk of all⁃cause mortality and major cardiovascular diseases,particularly among rural residents in China.These findings underscore the need to enhance mental health awareness and interventions to mitigate these risks and improve outcomes,especially in rural communities.

关 键 词：抑郁 全因死亡 主要心血管疾病 城乡地区 

分 类 号：R54[医药卫生—心血管疾病] R749.4[医药卫生—内科学]