摘要
目的:探讨冠状动脉旁路移植术(CABG)患者术前炎症标志物与术后抑郁障碍的关系。方法:收集2010-03至2010-09间在我院接受CABG患者的临床资料,同时术前采集患者血样,以检测血清中高敏C反应蛋白等炎症因子的水平。本研究应用PHQ-9抑郁量表,对患者术前、术后1个月、6个月的心理状况进行评估。以PHQ-9抑郁量表评分结果为观察终点,运用Logistic多因素回归分析的方法,确定CABG患者术前炎症标志物与术后抑郁障碍发生的关系。结果:研究共收集234例CABG患者,共计232例完成了随访,另外2例为院内死亡患者;平均年龄为(60.8±8.6)岁,其中女性比例为18.5%(43/232),CABG患者术前抑郁障碍者发生率为18.1%(42/232),术后1个月抑郁障碍者的发生率为14.7%(34/232),患者6个月抑郁障碍者发生率为18.1%(42/232)高于前者,且差异无统计学意义(P>0.05)。女性患者术后抑郁障碍者发生率明显高于男性患者(术后1个月随访结果:20.9%:13.2%,P=0.197;术后6个月随访结果:20.9%:17.5%,P=0.594)。术后抑郁障碍者血液中高敏C反应蛋白的水平显著高于非抑郁障碍者[术后1个月:(5.4±5.1)mg/L vs(3.0±2.9)mg/L,P<0.01;术后6个月:(4.9±4.7)mg/L vs(3.0±3.0)mg/L,P<0.05)]。Logis-tic回归分析显示:高敏C反应蛋白是术后1个月、6个月抑郁发生的独立危险因素。结论:本研究通过Logistic回归分析进行多因素调整,得出术前高敏C反应蛋白水平为影响CABG患者术后早中期抑郁障碍发生的独立危险因素。
Objective: To explore the relationship between pre-operative inflammatory marker and the post-operative depression occurrence in patients with coronary artery bypass grafting(CABG). Methods: We studied 234 patients undergoing CABG in our hospital from March to September 2010.2 patients died during hospitalization,and 232 patiewts finished 6 months follow-up study.The patients with the mean age of(60.8±8.6)years,the female ratio was 18.5%(43/232).We measured blood high sensitivity C-reactive protein(hs-CRP)in all patients at least 3 days before the operation.The depressive disorders at pre-operation,1 month and 6 months after the operation were accessed with patient health questionnaire(PHQ)by telephone visit.Taking PHQ-9 score as the end point,multivariable logistic regression was used to analyze the relationship between pre-operative hs-CRP level and the post-operative depression occurrence. Results: Pre-operative depressive disorder occurred in 18.1%(42/232)of patients.While 1 month post-operative depression was found in 14.7%(34/232),6 months post operation was 18.1%(42/232),P0.05.Depressive symptoms occurred more in female patieuls than male as 1 month post operation was 20.9% vs.13.2%,P=0.197,6 months post operation was 20.9% vs.17.5%,P=0.594.The hs-CRP level in patients with post-operative depression was significantly higher than those without it as 1 month post operation was(5.4±5.1)mg/L vs.(3.0±2.9)mg/L,P0.01,and 6 months post operation was(4.9±4.7)mg/L vs.(3.0±3.0)mg/L,P0.05.Logistic regression analysis indicated that circulating hs-CRP level was the independent risk factor for 1 month and 6 months post operative depression occurrence after CABG. Conclusion: With the adjusted multi-factors,pre-operative hs-CRP level is the indedepent risk factor for post-operative depression in CABG patients.
出处
《中国循环杂志》
CSCD
北大核心
2012年第2期122-125,共4页
Chinese Circulation Journal
基金
中央级公益性科研院所基本科研业务费专项资金(医科便函[2008]48号)
教育部新世纪优秀人才基金(医科便函[2011]48号)
卫生部行业基金(200902001)
关键词
冠状动脉旁路移植术
抑郁障碍
炎症标志物
危险因素
Coronary artery bypass grafting
Depressive disorder
Inflammation marker
Risk factor