老年高血压患者抑郁的患病率及与血浆同型半胱氨酸的相关性

Prevalence of Depression in Elderly Hypertension Patients and Its Relationship with Plasma Homocysteine

目的：分析老年高血压患者抑郁的发病情况,及其与血浆同型半胱氨酸（Hcy）的相关性,为早期干预治疗提供依据。方法：调查2011年1月-2014年6月我院收治的老年高血压患者403例,通过抑郁自评量表（SDS）了解其抑郁发病情况及抑郁程度,并分析其与血浆Hcy水平的相关性。结果：共调查403名老年高血压患者,抑郁的患病率为21.34%,男性患病率（17.23%）显著低于女性（27.27%）（χ^2=5.86,P〈0.05）,〉70岁年龄组抑郁的患病率（27.38%）明显高于60～70岁年龄组（17.02%）（χ^2=6.26,P〈0.05）;高血压Ⅲ级患者SDS评分明显高于高血压Ⅰ级、Ⅱ级患者（t=4.51,3.87;P〈0.05）;与轻度抑郁比较,中度、重度抑郁患者Hcy水平（t=4.52,4.72;P〈0.05）、SDS评分（t=3.91,6.52;P〈0.05）明显升高,叶酸水平（t=-5.16,-6.40;P〈0.05）明显下降;抑郁患者中Hcy水平与叶酸水平呈负相关（r=-0.438,P〈0.05）,与SDS评分呈正相关（r=0.587,P〈0.05）。结论：老年高血压患者抑郁的患病率较高,临床上结合血浆Hcy水平进行治疗,有助于血压的达标,降低心脑血管疾病的风险,改善预后。

Objective：To analyze the prevalence of depression in elderly hypertensive patients and its relationship with plasma homocysteine（Hcy）,in order to provide the basis for early intervention treatment.Methods：403 patients admitted in our hospital from 2011.12 to 2014.6 were involved.Self-rating depression scale（SDS） was used to record the prevalence and degree of depression,and its relationship with plasma Hcy was analyzed.Results：The prevalence of depression was 23.14%.The prevalence for the males was significantly lower than that for the females（17.23% vs.27.27%）,prevalence for aged older than 70 was significantly higher than that for aged 60-70（27.38% vs.17.02%）（χ^2= 5.86,6.26;P〈0.05））.SDS score in grade 3 hypertension patients was significantly higher in grade 1 and 2 hypertension patients（t = 4.51,3.87; P〈0.05）.Compared with mild depression,levels of plasma Hcy（t =4.52,4.72,P〈0.05） and SDS score（t = 3.91,6.52,P〈0.05） increased in patients with moderate and severe depression,level of folic acid significantly decreased（t =-5.16,-6.40,P〈0.05）.Levels of plasma Hcy in patients with depression was negatively correlated with folic acid level（r =-0.438,P〈0.05）,and positively correlated with SDS scores（r = 0.587,P〈0.05）.Conclusion：The prevalence of depression in elderly hypertensive patients is relatively high.Clinical treatment combined with plasma Hcy can contribute to control blood pressure,reduce the risk of cardiovascular disease,and improve the prognosis.