抑郁对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术短期预后的影响

Clinical study on the effect of depression at the short clinical outcome in patients with ST-elevated myocardi. al infarction treated with percutaneous coronary intervention

目的 研究急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）术前后合并抑郁对术后短期临床预后的影响.方法 研究对象为2006年6月15日至2009年6月15日在青岛大学医学院第二附属医院心内科住院的患者.采用巢式病例对照研究方法建立匹配病例对照研究.共入选209例患者,分为抑郁组72例和非抑郁组137例.比较2组患者随访12个月的全因死亡时间（一级观察终点）和重要心血管事件（二级观察终点）.结果 2组患者一般资料差异无统计学意义,具有可比性（P＞0.05）.随访12个月,抑郁组死亡4例（5.6%）,非抑郁组死亡3例（2.2%）,2组病死率差异无统计学意义（P=0.199）;抑郁组患者重要心血管事件发生率[20.8%（15例）]明显高于非抑郁组[9.5%（13例）],差异有统计学意义（P=0.022）.在二级终点中,只有严重心律失常的发生率差异有统计学意义[9.7%（7例）比2.9%（2例）,P=0.036].结论 STEMI患者PCI术前后合并抑郁,可使患者临床事件增加.

Objective To investigate the effect of depression on the short clinical outcome in patients with ST-elevated myocardial infarction （STEMI） treated with percutaneous coronary intervention. Methods A nested and matched case-control study was performed. Totally 209 patients with STEMI were enrolled and divided into two groups： 72 patients with depression and 137 patients without depression. Major adverse cardiac events （MACE）were observed as the composite end points. MACE was compared between these two groups by the end of a 12-month follow-up after PCI. Results After a 12-month follow-up, the MACE rate of STEMI patients with depression was higher than that of patients without depression. Mortality rate in both groups did not have significant difference. The incidence of malignant arrhythmia was significantly different between the two groups. Conclusion Depression can induce a bad clinical outcome in STEMI patients treated with percutaneous coronary intervention.