急性心肌梗死患者急诊经皮冠状动脉介入治疗前不良情绪发生的影响因素分析  

Analysis of factors influencing the occurrence of adverse emotions before emergency percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：顾文雅 桑盛敏 钱晶[2] 顾勣 Gu Wenya;Sang Shengmin;Qian Jing;Gu Ji(Department of Emergency,Hai'an People's Hospital Affiliated to Nantong University,Nantong 226600,Jiangsu,China;Department of Cardiology,Hai'an People's Hospital Affiliated to Nantong University,Nantong 226600,Jiangsu,China;Department of Intervention,Hai'an People's Hospital Affiliated to Nantong University,Nantong 226600,Jiangsu,China)

机构地区：[1]南通大学附属海安市人民医院急诊科,江苏南通226600 [2]南通大学附属海安市人民医院心内科,江苏南通226600 [3]南通大学附属海安市人民医院介入科,江苏南通226600

出　　处：《血管与腔内血管外科杂志》2025年第3期423-428,共6页Journal of Vascular and Endovascular Surgery

基　　金：南通市自然科学基金和社会民生科技计划项目(MSZ2023046)。

摘　　要：目的探究急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)前不良情绪发生的影响因素及预测价值。方法收集2021年8月至2023年9月南通大学附属海安市人民医院收治的196例AMI患者的临床资料,统计所有患者PCI前不良情绪的发生情况。评估所有AMI患者的焦虑子量表(HADS-A)评分和抑郁子量表(HADS-D)评分,分析AMI患者急诊PCI前产生焦虑情绪与抑郁情绪的相关性,采用多因素Logistic回归模型分析AMI患者急诊PCI前不良情绪发生的危险因素。结果所有AMI患者的HADS-A评分为(9.87±3.62)分,HADS-D评分为(7.16±2.32)分。单因素分析结果显示,经济水平低的患者的HADS-A评分、HADS-D评分均高于经济水平高的患者,不绕行急诊或冠心病监护病房(CCU)的患者的HADS-A评分、HADS-D评分均高于绕行急诊或CCU的患者,5-羟色胺(5-HT)表达水平﹤105 ng/ml的患者的HADS-A评分、HADS-D评分均高于5-HT表达水平≥105 ng/ml的患者,差异均有统计学意义(P﹤0.05)。相关性分析结果显示,AMI患者急诊PCI前的HADS-A与HADS-D呈正相关(r=0.264,P=0.009)。多因素分析结果显示,经济水平低、绕行急诊或CCU和5-HT表达水平﹤105 ng/ml均是AMI患者急诊PCI前产生焦虑、抑郁情绪的独立危险因素(P﹤0.05)。结论经济水平低、绕行急诊或CCU、5-HT﹤105 ng/ml均是AMI患者PCI前产生不良情绪的独立危险因素。Objective To investigate the influencing factors and predictive value of adverse emotions in patients with acute myocardial infarction(AMI)before emergency percutaneous coronary intervention(PCI).Method Clinical data of 96 patients with AMI admitted to Hai'an People's Hospital Affiliated to Nantong University from August 2021 to September 2023 were collected to study the occurrence of adverse emotions before PCI.The hospital anxiety and depression scale-anxiety(HADS-A)and hospital anxiety and depression scale-depression(HADS-D)scores of all AMI patients were evaluated,the correlation between anxiety and depression before emergency PCI in AMI patients was analyzed,multiple factor Logistic regression model was used to analyze the risk factors for adverse emotions before emergency PCI in AMI patients.Result The HADS-A score of all AMI patients was(9.873.62)and the HADS-D score of all AMI patients was(7.16±2.32).The results of univariate analysis showed that patients with low economic level had higher HADS-A and HADS-D scores than those with high economic level.Patients who did not bypass the emergency or coronary care unit(CCU)had higher HADS-A and HADS-D scores than those who bypassed.Patients with 5-hydroxytryptamine(5-HT)expression levels<105 ng/ml had higher HADS-A and HADS-D scores than those with 5-HT expression levels≥105 ng/ml,and the differences were statistically significant(P<0.05).The correlation analysis results showed that there was a positive correlation between HADS-A and HADS-D in AMI patients before emergency PCI(r=0.264,P=0.009).The results of multivariate analysis showed that low economic level,bypassing emergency or CCU,and serum 5-HT expression level<105 ng/ml were independent risk factors for anxiety and depression in AMI patients before emergency PCI(P<0.05).Conclusion Low economic level,bypassing emergency or CCU,and 5-HT<105 ng/ml were the risk factors for adverse emotions before emergency PCI in AMI patients.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 影响因素 

分 类 号：R543[医药卫生—心血管疾病]