冠状动脉旁路移植术后患者抑郁焦虑状况及相关因素分析

Investigation of depression and anxiety state after coronary artery bypass grafting and analysis of influen- tial factors correlated

目的调查冠状动脉旁路移植（coronary artery bypass grafting，CABG）术后患者抑郁焦虑状态的发生率，并分析相关的影响因素。方法以2005年7月至2006年6月在北京大学第一医院心脏外科行择期CABG手术的91例患者为研究对象，术前、术后使用抑郁自评量表和焦虑自评量表进行评分，根据术后是否存在抑郁焦虑状态把患者分成抑郁焦虑组和非抑郁焦虑组。以患者人口学特征、病变程度、合并症以及手术相关特点与术后抑郁焦虑进行相关因素分析。结果89例患者完成测试，手术后共有41例（46．1％）阳性患者。Logistic退步法回归分析，高脂血症（OR 3．958，95％CI 1．016～7．689）、术前心血管事件（OR 4．285，95％CI 1．051～6．175）、术前脑梗死（OR 3．095，95％CI 0．783～2．426）、术前存在抑郁焦虑症状（OR 13．775，95％CI 2．805～8．207）是术后发生抑郁焦虑的风险因素。结论CABG术后抑郁焦虑有一定的发生率，需要引起重视，同时高脂血症、术前心血管事件、术前脑梗死、术前存在抑郁焦虑症状可能是术后发生抑郁焦虑的风险因素。

Objective To investigate the incidence of depression and anxiety post-operation of coronary artery bypass grafting （CABG） and analysis the correlated factor. Methods 91 patients underwent scheduled CABG in the first hospital of Peking University from July 2005 to June 2006. The patients were interviewed to assess depression and anxiety symptoms using self-rating depression scale （SDS） and self-rating anxiety scale （SAS） before operation and before discharge. The patients were divided into depression and anxiety group and no depression and anxiety group according to with or without depression and anxiety. Demography characteristic, medical, surgical risk factors were assessed during surgery. Results 89 patients completed evaluation. 41 patients （46.1%） had depression and/or anxiety symptoms after CABG. Hyperlipemia（ OR 3. 958,95% CI 1. 016 7. 689 ）, heart blood vessel event （ OR 4. 285,95% CI 1.051 - 6.175 ）, depression and anxiety （ OR 3. 095,95% CI 0. 783 - 2. 426）, cerebral infarction（ OR 13. 775,95% CI 2. 805 - 8. 207 ） before operation are risk factors for depression and anxiety post surgery. Conclusion The incidence rate of depression and anxiety post CABG is high and should be paid more attention. Hyperlipemia, heart blood vessel event, depression and anxiety, cerebral infarction before operation are possible risk factors for depression and anxiety post surgery.