糖尿病合并冠心病患者介入治疗后焦虑、抑郁状况分析

Analysis of anxiety and depression after percutaneous coronary intervention for patients coronary heart diseases with diabetes mellitus

目的探讨冠脉介入手术前后，糖尿病合并冠心病患者焦虑、抑郁发病率以及发病原因。方法选择184例接受PCI治疗的糖尿病合并冠心病患者，采用焦虑白评量表（SAS）、抑郁自评量表（SDS），观察术前术后焦虑或抑郁状态的变化，对术后合并有焦虑、抑郁的患者进行自制问卷调查。结果184例患者手术前后SAS和SAD差异无统计学意义（P〉0．05）。手术前合并焦虑的患者为92例，占50．oo％，合并抑郁的患者为59例，占32．07％，两者同时合并的为26例，占14．13％。手术后合并焦虑的患者为94例，占51．09％，而合并抑郁的患者为60例，占32．61％，两者同时合并的为27例，占14．67％。患者焦虑抑郁的主要原因依次为：（1）日常活动受影响50．0％（56／112）；（2）支架内再狭窄、再次手术42．0％（47／112）；（3）长期服用药物所产生的高昂费用30．4％（34／112）；（4）术后抗凝药与糖尿病药物的不良反应20．5％（23／112）。结论虽然术后SAS和SDS评分较术前无显著性差异，但PCI术后糖尿病合并冠心病患者合并焦虑与抑郁发生率均较高，因此有必要对其进行联合心理干预的治疗。

Objective To explore the incidence of anxiety and depression in patients with coronary heart diseases （CHD） acommpanying diabetes mellitus befor and after percutaneous coronary intervention（PCI）. Methods To select 184 patients with CHD acommpanying diabetes mellitus who receiced the PCI. The SAS,SDS investigation were used to observe the anxiety and depression befor and after the operation. All of those who had anxiety and/or depes- sion accepted self-control questionnaire investigation. Results There was no significant difference between the SAS and SDS of 184 patients befor and after the PCI. 50.00 % （92 cases） PCI patients had anxiety,32.07% （59 cases） PCI patients had depression respectively, 14.13%（26 cases） had both anxiety and depression preoperatively. And postop- eration 51. 09% （94 cases） PCI patients had anxiety, 32.61 % （60 cases） PCI patients had depression respectively, 14.67% （27 cases） had both anxiety and depression preoperatively. The major causes of anxiety and depression were： （ 1 ） daily activities were limitation 50.0% （56/112） ; （2） in stentrestenosis, reoperation 42.0% （47 / 112） ; （3） the costly expense of medicine 30.4% （34/112）;（4）the side effect of anticoagulant drug and medicine fuer diabetes 20.5% （23/112）. Conclusion The patients with PCI have high incidence of anxiety and depression. So it is necessary for patients to be cured combine with psychological therapy.