青年冠状动脉粥样硬化性心脏病伴抑郁症患者的临床特征及相关因素研究

Depression in young coronary heart disease patients and related risk factors

目的 探讨青年冠状动脉粥样硬化性心脏病（冠心病）伴抑郁症患者的临床特点、相关因素及预后.方法 选择青年冠心病伴抑郁症患者76例为观察组,青年冠心病不伴抑郁症患者70例为对照组.对2组患者的临床特点、家庭及社会支持以及冠状动脉造影的结果进行分析对比并随访.结果 观察组患者严重睡眠障碍、焦虑激越、情绪低落、兴趣减退、自觉无用负罪感等症状的发生率与对照组比较差异有统计学意义.对照组的家庭和睦及社会支持率明显高于观察组（64.3%比26.3%,P＜0.01）.动脉造影显示,观察组与对照组患者冠状动脉病变程度无明显差异.随访急性冠状动脉综合征（ACS）发生率、再住院率等指标观察组均明显高于对照组（15.8%比1.4%,36.8%比12.9%,P＜0.05）.结论 青年冠心病伴抑郁症患者易产生严重睡眠障碍、焦虑激越、情绪低落、兴趣减退等症状;ACS发生率明显增高;临床要高度重视青年冠心病伴发抑郁症,积极识别及时治疗,有助青年冠心病患者预后改善,社会及家庭意义重大.

Objective To study the clinical characteristics of young coronary heart disease （CHD）patients suffering from depression. Methods The clinical data of 76 young CHD patients with depression （depression group） and 70 young CHD patients without depression （none-depression group）were enrolled. Clinical characteristics, family and social support, coronary angiography results of the two groups were followed up and compared.Results Severe sleep disorders, anxiety, agitation, depression in depression group were significantly higher than those in none-depression group （ P 〈 0.05 ）. Family harmony and social support in depression group were significantly lower than those in none-depression group （ P 〈 0. 01 ）. Angiography showed no significant difference between the 2 groups. Re-admission rate was significantly higher due to acute coronary syndrome （ACS） in depression group （P 〈0.05）. Conclusions Young CHD patients with depression have high chance of suffering from sleep disorder,anxiety, agitation, depression, diminished interest and other complications such as ACS. Early identification and aggressive treatment can help improve the prognosis of young patients CHD with depression.