急性冠脉综合征后抑郁情绪对生存质量的影响

Research on the relationship of depressive symptoms to the quality of life in patients with acute coronary syndrome

目的:调查急性冠脉综合征(ACS)患者抑郁情绪的时点患病率,了解其对患者生存质量的影响。方法:收集上海地区ACS患者454例,运用医院焦虑抑郁量表抑郁亚量表(hospital anxiety and depression scale-depression sub-scale,HADS-D)评分分为抑郁情绪组(HADd>7分)和无抑郁情绪组(HADd≤7分),并使用SF-36量表评估其生存质量。结果:合并抑郁情绪患者212例,时点患病率为46.7%;两组人群血脂及炎症因子水平差异无显著性意义(P>0.05);抑郁组全部生存质量评分均显著低于无抑郁情绪组(P<0.001);HADS-D抑郁评分与患者生存质量评分显著负相关(P<0.001)。结论:ACS后抑郁情绪较为常见,使患者生存质量明显降低。

Objective：To present a general data about Chinese patients＇ depressive symptoms of acute coronary syndrome（ACS）, and evaluate the impact of this kind of symptoms on their quality of life（QOL）. Method： A total of 454 Chinese patients with ACS from Shanghai were enrolled. The patients＇ baseline data were obtained within 1 week after hospital admission. The Chinese version of depression subscale of the Hospital Anxiety and Depression Scale（HADS-D） and SF-36 were used to assess depressive symptoms and their QOL, respectively. All the partici- pants were divided into two main groups： HADd〉7 （n=212） and HADa≤7 （n=242）. Result： There were 46.7% of 454 ACS patients meeting the criteria of minor depression. The baseline characteristics, including the level of in- flammatory factor and blood cholesterol, didn＇t show a significant difference between two groups （P〉0.05）. The participants from the group without depressive symptoms had a better QOL than depressive group （P〈0.001）. And depressive symptoms were negatively associated with QOL（P〈0.001）. Logistic regression analysis didn＇t suggest that inflammatory factor was an important risk factor for depressive symptoms of ACS patients. Conclusion： This study confirmed the western notion that post-ACS depressive symptoms are common psychosocial problems, which also applies to Chinese patients diagnosed with ACS. Depressive ACS patients have rather worse quality of life.