胸痛患者伴随抑郁情况的研究

A study on depression in patients with chest pain

目的 了解因胸痛住院、行冠状动脉介入诊疗的患者伴随抑郁的情况及冠心病患者伴随抑郁的相关危险因素.方法 154名准备行冠状动脉介入手术且符合条件的患者入选.应用抑郁自评量表对所有患者于术前2 d内进行评分.结果118例冠心病（冠状动脉造影阳性）患者中51例（43.2%）伴随抑郁;36例非冠心病（冠状动脉造影阴性）患者中8例（22.2%）伴随抑郁,两组间差异有统计学意义.伴随抑郁者出现冠心病的比值比（OR）为2.44（95%CI 1.01～5.90,P=0.047）.对于冠心病患者来说,合并糖尿病、心绞痛症状重、心功能分级差、有生活事件、高收入者伴随抑郁的OR值分别为2.85（95%CI 1.21～6.73,P=0.017）、2.84（95%CI 1.09～7.39,P=0.033）、3.97（95%CI 1.23～12.79,P=0.021）、3.57（95%CI 1.32～9.66,P=0.012）、0.29（95%CI 0.09～0.88,P=0.029）.冠心病伴或不伴随抑郁其冠状动脉病变严重程度差异无统计学意义.结论 冠心病患者中抑郁患病率高,抑郁是冠心病的独立危险因素;糖尿病、心绞痛症状重、心功能差、有生活事件是冠心病患者出现抑郁的危险因素,而高收入是抑郁的保护因素;抑郁与冠状动脉病变严重程度无关.

Objective To evaluate the prevalence of depression in patients with chest pain and undergoing scheduled percutaneous coronary intervention and to study the risk factors of depression in patients with coronary artery disease （CAD）. Methods Totally, 154 patients with scheduled coronary intervention according in line with the inclusion criteria were enrolled. All patients were scored by self-rating depression scale （SDS） two days before coronary angiography （CAG）. Results Fifty-one （43.2%） of 118 patients with CAD and eight （22. 2% ） of 36 patients without CAD had depression, with a statistically significant difference （P 〈0. 05 ）. Odds ratio （OR） for CAD in patients with depression was 2.44, with 95% confidence interval （CI） of 1.01 - 5. 90 （ P = 0. 047 ）. OR for depression in CAD patients with diabetes mellitus, severe angina pectoris, worse heart function, negative life events and higher level of income was 2. 85 （95% CI 1.21 - 6. 73, P = 0. 017）, 2. 84 （95% CI 1.09 - 7.39, P = 0. 033）, 3.97 （95%CI1.23-12.79, P=0.021）, 3.57 （95%CI1.32-9.66, P=0.012） and0.29 （95% CI 0. 09 - 0. 88, P = 0. 029） , respectively. There was no significant difference in the severity of diseased vessels between CAD patients with or without depression. Conclusions Depression was an independent risk factor for CAD, with higher prevalence of depressive symptoms in patients with CAD. Diabetes mellitus, severe angina pectoris, worse heart function and negative life events were all risk factors of depression in patients with CAD, and higher level of income in patients was a protective factor. Depression was not related to the severity of eoronary artery lesions. [ Key wards]