快速心律失常复发再次行射频消融术患者焦虑抑郁情况调查

Occurrence of anxiety and depression in patients with recurrent rapid arrhythmia undergone second radiofrequency ablation

目的了解快速心律失常复发再次行射频消融患者焦虑抑郁情况。方法连续收集北京军区总医院心血管内科病房2013年11月至2014年5月间收治的心律失常初次行射频消融治疗(初次组,n=50)及术后复发再次行射频消融治疗的心律失常患者(二次组,n=50)共100例,其中男性55例,女性45例。于术前填写贝克-抑郁量表、状态-焦虑量表、自制担心问卷调查表,评估患者的焦虑抑郁情况。分析影响焦虑抑郁的因素。结果二次组焦虑评分较初次组升高[(42.1±9.1)分vs.(39.7±8.7)分],二次组较初次组术前更担心手术疗效、术后并发症及费用问题,差异有统计学意义(P均<0.05)。心房纤颤(房颤)患者焦虑评分、抑郁评分均明显高于非房颤患者,差异有统计学意义(P均<0.05)。在α=0.05水平时,与焦虑评分有关的因素有组别(β=3.14,P=0.01)、年龄(β=-0.14,P=0.02)、受教育程度(β=0.04,P=0.03)、房颤(β=-0.35,P=0.03)、手术疗效(β=1.76,P=0.04);影响抑郁评分的变量有年龄(β=0.23,P=0.04)、手术费用(β=-0.44,P=0.03)。结论快速心律失常复发再次行射频消融患者焦虑水平明显高于初次行射频消融患者,应予以关注。

Objective To observe the occurrence of anxiety and depression in patients with recurrent rapid arrhythmia undergone second radiofrequency ablation （RFA）. Methods The patients （n=100, male 55 and female 45） with arrhythmia undergone first RFA （first group） and those undergone second RFA （second group, each n=50） were chosen from Nov. 2013 to May 2014. All patients were asked to fill Beck Depression Inventory （BDI）, State-Trait Anxiety Inventory （STAI） and self-made worry questionnaire for reviewing patients’ anxiety and depression status. The factors affecting anxiety and depression were analyzed. Results The anxiety scores were higher in second group than those in first group [（42.1±9.1） vs. （39.7±8.7）], and second group worried more about curative effect, postoperative complications and cost （all P〈0.05）. The anxiety scores and depression scores were significantly higher in patients with atrial fibrillation （AF） than those in non-AF patients （all P〈0.05）. Whenα=0.05, the factors related to anxiety scores included grouping （β=3.14, P=0.01）, age （β=-0.14, P=0.02）, educational background （β=0.04, P=0.03）, AF （β=-0.35, P=0.03） and curative effect （β=1.76, P=0.04）. The variables affecting depression scores included age （β=0.23, P=0.04） and cost （β=-0.44, P=0.03）. Conclusion The anxiety level is significantly higher in patients with recurrent rapid arrhythmia undergone second RFA than that in those with first RFA, which should be paid more attention to.