老年糖尿病合并急性心肌梗死患者抑郁焦虑状况研究

Depression and Anxiety State in Elder Diabetes Mellitus Patients with Acute Myocardial Infarction

目的探讨老年糖尿病合并心肌梗死患者的焦虑、抑郁状态及其并发症发生情况。方法将232例60岁以上老年急性心肌梗死患者分为糖尿病合并心肌梗死组(128例,DM-AMI组)和非糖尿病合并心肌梗死组(104例,NDM-AMI组),采用问卷调查的方法对患者抑郁、焦虑状态进行评价,并记录患者并发心律失常、心力衰竭、心源性休克的情况,以及死亡患者例数。结果 DM-AMI组焦虑、抑郁评分分别为(62±12)分和(60±12)分,明显高于NDM-AMI组的(52±10)分和(52±10)分,差异有统计学意义(t值分别为6.97和5.68,P<0.001);DM-AMI组焦虑程度:轻度28例、中度25例、重度13例;抑郁程度:轻度20例、中度16例、重度10例。NDM-AMI组焦虑程度轻度25例、中度10例、重度3例;抑郁程度:轻度16例、中度5例、重度2例。两组患者焦虑和抑郁的程度间差异有统计学意义(u值分别为5.67和4.25,P=0.04)。同时合并抑郁或焦虑的心肌梗死患者的心律失常、心力衰竭和心源性休克的发生率明显高于无抑郁或焦虑患者(χ2值分别为4.89,11.98,4.24;P=0.03,0.00,0.04)。结论老年糖尿病合并急性心肌梗死患者更易出现焦虑抑郁、情绪,急性心肌梗死患者并发症的发生与抑郁、焦虑状态相关。

Objective To analyze depression and anxiety state in elder patients with diabetes mellitus （DM） complicated by acute myocardial infarction （AMI）.Methods Totally 232 elder patients aged more that 60 with AMI were divided as DM-AMI （DM complicated by AMI,n=128） group and NDM-AMI （non-diabetes complicated by AMI,n=104） group.The questionnaire surveys were used to evaluate the depression and anxiety status of the patients,and the complications of cardiac arrhythmia,acute left heart failure,cardiac shock,as well as death cases were also recorded.Results The scores of anxiety and depression in the DM-AMI group were （62±12） and （60±12）,with significant differences as compared with（52±10） and （52±10） in the NDM-AMI group （t=6.97,5.68,P0.001）.There were in the DM-AMI group 28 patients with mild degree of anxiety,25 with meddle degree,and 13 with severe degree;20 with mild degree of depression,16 with meddle degree,and 10 with severe degree.While in the NDM-AMI group there were 25 patients with mild degree of anxiety,10 with meddle degree and 3 with severe degree;16 with mild degree of depression,5 with meddle degree,and 2 with severe degree.There were significant differences in degrees of anxiety and depression between the two groups （u=5.67,4.25,P=0.04）.Meanwhile,the incidences of cardiac arrhythmia,cardiac failure and cardiac shock were higher in AMI patients with depression or anxiety than those without （χ2= 4.89,11.98,4.24,P=0.03,0.00,0.04）.Conclusion The elder patients with DM complicated AMI are susceptible to suffer from depression or anxiety.And the incidences of AMI complications are related to depression or anxiety.