抑郁对急性冠状动脉综合征预后的影响

The correlation between depression and prognosis in patients with acute coronary syndrome

目的研究抑郁对急性冠脉综合征(ACS)预后的影响。方法将临床确诊为ACS的262例患者分为抑郁组与非抑郁组,比较两组的近期心血管事件发生率及分析抑郁与各心血管事件的关系,了解ACS并抑郁患者心率变异性(HRV)的变化和抑郁与HRV的相关性。结果ACS并抑郁患者心绞痛、急性ST段抬高心肌梗死、急性非ST段抬高心肌梗死、心力衰竭、短阵室性心动过速、心室颤动、心脏性死亡的发生率分别为40.8%,11.4%,19.4%,21.4%,13.3%,9.4%和8.2%。抑郁均为各心血管事件发生的独立预测因素。ACS并抑郁患者时域指标、高频功率均低于非抑郁组,极低频功率、低频功率高于非抑郁组。抑郁严重度指数与HRV各指标相关。结论ACS并抑郁患者心血管事件的发生率增加,抑郁为各心血管事件发生的独立预测因素。

Objective To investigate primarily the correlation between depression and prognosis in patients with acute coronary syndrome（ACS）. Methods Two hundred and sixty-two ACS patients were divided into depression group and non- depression group. The relation between depression and incidence of short-term cardiovascular events were compared. The change of HRV and correlation between depression and HRV were analysed in the ACS patients complicated with depression. Results The incidence of angina pectoris, ST-segement elevated myocardial infarction, non ST-segement elevated myocardial infrrction, congestive heart failure, ventricular tarchycardia, ventricular fibrillation and sudden death in the near future were 40.8% , 11.4% , 19.4% ,21.4% , 13.3% ,9.4% and 8.2% respectively. Depression were all the independent predictive factor of the cardiovascular events . The SDNN, SDANN, SDNN index, RMSSD,PNN50 and high frequency power were lower and very low frequency power, low frequency power were higher in the depression group than that in non- depression group . Depression seriousness index correlated with all the HRV index. Conclusion HRV changes and correlates with depression in the ACS patients complicated by depression. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2007,21 （ 3 ） ：236 - 238 ]