急性肺栓塞患者焦虑抑郁状态与肺栓塞严重程度分析

Analysis of anxiety and depression of acute pulmonary embolism and pulmonary embolism severity index

目的探讨急性肺栓塞（APE）患者焦虑抑郁状态情况并对肺栓塞严重程度进行分析,提高对APE的认识水平。方法收集2013年10月至2014年10月间收治于我院经CT肺动脉造影（CTPA）和肺通气/灌注扫描确诊的82例APE住院患者,分成老年组（≥65岁）40例和非老年组（18-64岁）42例。住院当日给予肺栓塞严重指数（PESI）评分,住院一周内给予焦虑自评量表（SAS）、抑郁自评量表（SDS）测评,测定标准分,并对患者焦虑抑郁状态和PESI之间的关系等进行分析。结果老年组有焦虑抑郁症状的患者9例,占22.5%（9/40）,非老年组有焦虑抑郁症状的19例,占45.2%（19/42）,两组比较有统计学差异（P=0.03）。APE患者年龄和抑郁程度呈负相关（r=-0.228,P=0.04）,患者年龄和PESI呈正相关（r=0.343,P=0.002）;患者焦虑、抑郁状态与PESI无相关性（r=-0.034,P=0.76;r=-0.069,P=0.54）。结论 APE患者焦虑抑郁状态发病率高,非老年患者更易合并焦虑抑郁状态,值得临床关注。随着年龄的增长,APE的严重程度增加,但抑郁程度呈下降趋势。焦虑抑郁状态并不影响APE患者的严重程度,但可能是非老年APE患者的危险因素。

Objective To analyze the clinical characteristics of anxiety,depression of the patients with acute pulmonary embolism and PESI,improve doctors＇ awareness of acute pulmonary embolism. Methods 82 cases were diagnosed as acute pulmonary embolism by CTPA and lung ventilation / perfusion scan from October2013 to October 2014 in our hospital. The cases were divided into two groups,the elderly group（ ≥65 years old） and the non-elderly group（ 18-64 years old）. They were given SAS,SDS in one week and PESI scale evaluation in the first day,the data were analyzed about anxiety,depression and PESI. Results 9 cases with symptoms of anxiety and depression in the elderly group,accounting for 22.5%（ 9 / 40）.19 cases with symptoms of anxiety and depression in the non-elderly group,accounting for 45. 2%（ 19 / 42）. There was statistical difference between the two groups（ P = 0.03）. The degree of depression was negatively related to the age of APE patients（ r =- 0. 228,P = 0. 04）. The PESI was positive related to the age of APE patients（ r = 0. 343,P =0.002）. There is no relevant between PESI and anxiety and depression（ r =-0.034,P = 0.76; r =- 0.069,P =0.54）. Conclusions The incidence of anxiety and depression in the patients with APE is high. The nonelderly is more vulnerable to anxiety and depression than the elderly,more attention should be given to the nonelderly. As the growth of the age,severity of the APE increases,but the degree of depression is on the decline.The degree of anxiety and depression of the patients with APE does not affect pulmonary embolism severity,but it may be a risk factor for non-elderly patients with APE.