稳定型冠心病患者重性抑郁症发病与C反应蛋白水平相关性研究

Study on Correlation Between Major Depressive Disorder and C-reactive Protein in Patients with Stable Coronary Heart Disease

目的本研究在排除了其他潜在的精神并存症的基础上,综合性评价稳定型冠心病(CHD)患者重性抑郁症(MDD)发病情况,并考察其与心脏生物标志物如C反应蛋白(CRP)、肌钙蛋白T(TnT)以及氨基末端前B型脑钠素(NT-proBNP)水平的关系。方法横向考察72例稳定型CHD患者(30例患MDD,42例无精神疾病)。精神病学诊断标准依照中国精神疾病诊断标准CCMD-II-R,以CRP、TnT和NT-proBNP作为因变量,MDD、人口统计特征及地区医疗条件为恒变量进行回归分析。结果多元逐次回归分析显示,CRP水平与MDD有显著相关性(r=0.262,P=0.02),而与其他恒变量如人口统计学特征及医疗水平无关。另外研究结果表明Ⅱ型糖尿病与TnT(r=0.267,P=0.02)、年龄与NT-proBNP(r=0.374,P=0.001)之间亦有显著相关性。结论稳定型冠心病患者患重性抑郁症几率与CRP水平增高密切相关。

Objective To comprehensively evaluate the prevalence of major depressive disorder （MDD） in stable coronary heart disease （GriD） patients on the basis of excluding other potential psychiatric comorbidities, and to explore the correlation between MDD and cardiac biomarkers, including Oreactive protein （CRP）, troponin T （TnT）, and aminoterminal pro- B type brain natriuretic peptide （NT proBNP）. Methods A cross sectional study was conducted among 72 outpatients with stable GriD, including 30 MDD patients and 42 patients without psychiatric disorder. Psychiatric diagnosis stan- dards were established by using the CCMD - II - R. Regression analyses were performed including CRP, TnT, and NT proB- NP as dependent variables, and MDD, demographic features, and local medical condition as independent variables. Results Stepwise multiple regression analyses showed that MDD was significantly correlated with CRP level （ r = 0. 262, P = 0.02）, while MDD was not relevant to demographic and medical variables. In addition, the results described a significant association between type II diabetes mellitus and TnT （r = 0. 267, P- 0.02）, and also between age and NT- proBNP level （r = 0. 374, P = 0. 001 ）. Conclusions Major depressive disorder is closely related to elevated CRP level in stable CHD patients.