焦虑抑郁对冠心病患者经皮冠状动脉介入治疗预后的影响

Influence of anxiety-depression on prognosis in patients with coronary heart disease after percutaneous coronary intervention

目的探讨焦虑抑郁状态对冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入治疗(PCI)预后的影响。方法选择2013年1月~10月于武警后勤学院附属医院心血管内科住院的冠心病患者96例,其中男性58例,女性38例,平均年龄(57.0±10.4)岁。PCI术后3 d内对入选者采用焦虑自评量表(SAS)及抑郁自评量表(SDS)进行测评。根据量表测评结果分为焦虑抑郁组(25例)和对照组(71例)。随访两组术后12个月内主要不良心血管事件(MACE)发生情况。结果与对照组比较,焦虑抑郁组焦虑自评量表得分、抑郁自评量表得分均升高,差异有统计学意义(P均<0.05)。焦虑抑郁组MACE发生率高于对照组(28.0%vs.14.1%),差异有统计学意义(P<0.01)。多因素COX回归分析显示,焦虑抑郁状态(OR=1.58,95%CI:1.053~2.364)、吸烟(OR=1.78,95%CI:1.387~2.926)、高血压(OR=1.87,95%CI:1.453~2.961)、2型糖尿病(OR=2.13,95%CI:1.642~3.215)是影响冠心病患者PCI术后12个月内MACE发生的独立危险因素。结论焦虑抑郁状态是冠心病患者经皮冠状动脉介入治疗预后的影响因素。

Objective To investigate the influence of anxiety-depression status on the prognosis in patients with coronary heart disease （CHD） after percutaneous coronary intervention （PCI）. Methods CHD patients （n=96, male 58, female 38 and average age=57.0±10.4） were chosen from the Department of Cardiovascular Diseases in the Affiliated Hospital of Logistics University of People’s Armed Police from Jan. 2013 to Oct. 2013. All patients were given appraisals by using self-rating anxiety scale （SAS） and self-rating depressive scale （SDS） within 3 d after PCI, and then they were divided, according to the results of the appraisals, into anxiety-depression group （n=25） and control group （n=71）. The occurrence of major adverse cardiovascular events （MACE） was followed up in 2 groups within 12 m after PCI. Results The scores of SAS and SDS increased in anxiety-depression group compared with control group （all P〈0.05）. The incidence of MACE was higher in anxiety-depression group than that in control group （28.0% vs. 14.1%, P〈0.01）. The results of multi-factor COX regression analysis showed that anxiety-depression status （OR=1.58, 95%CI： 1.053~2.364）, smoking （OR=1.78, 95%CI： 1.387~2.926）, hypertension （OR=1.87, 95%CI： 1.453~2.961）, and type 2 diabetes mellitus （T2DM, OR=2.13, 95%CI： 1.642~3.215） were independent risk factors of MACE in CHD patients within 12 m after PCI. Conclusion The status of anxiety-depression is an influencing factor on prognosis in CHD patients after PCI.