慢性心力衰竭患者血脂水平与抑郁的相关性

Association between serum lipid level and depression in patients with chronic heart failure

目的探讨慢性心力衰竭（CHF）患者血清中血脂水平与抑郁的相关性。方法选取2016年9月至2017年6月于陕西省人民医院心血管内一科住院治疗的348例CHF患者，采用汉密尔顿抑郁量表（HAMD）评估其抑郁程度，测定相关临床指标。对上述患者的血脂水平与抑郁评分进行Pearson相关分析，并对抑郁相关因素进行Logistic回归分析。结果血脂正常组（51.9%）与血脂异常组（62.9%）的抑郁人数比例差异具有统计学意义（P＝0.044），Pearson相关分析显示抑郁评分与总胆固醇（r＝0.326，P〈0.001）及低密度脂蛋白胆固醇（r＝0.354，P〈0.001）呈线性相关，Logistic回归分析显示在校正年龄、体质指数、三酰甘油、低密度脂蛋白胆固醇、肌酐、总胆红素、白蛋白、B型脑钠肽后，总胆固醇（OR＝3.523，P＝0.007）及高密度脂蛋白胆固醇（OR＝0.205，P＝0.041）在CHF患者中与抑郁相关。 结论总胆固醇可增加CHF患者抑郁发生的危险性，高密度脂蛋白胆固醇可降低CHF患者抑郁发生的危险性。

Objective To investigate the association between serum lipid level and depression in patients with chronic heart failure （CHF）. Methods A total of 348 patients with CHF from the First department of Cardiology of the people＇s hospital of Shaanxi province from September 2016 to June 2017 were included. The Hamilton Depression Scale （HAMD） was used to evaluate the degree of depression and some related clinical data were tested. The serum lipid level and depression scores in the patients were analyzed using Pearson correlation analysis, and Logistic regression analysis was used to analyze the confounding factors of depression. Results There was significant difference in the proportion of depression between normal serum lipid group and dyslipidemia group （ P = 0. 044 ）. Pearson correlation analysis showed that depression score was linearly related to total cholesterol （r = 0. 326, P 〈 0. 001 ） and low density lipoprotein cholesterol （ r = 0. 354, P 〈 0. 001 ） , and Logistic regression analysis showed that after adjusting for age, BMI, triglyceride, low density lipoprotein cholesterol, creatinine, total bilirubin, albumin, B type natriuretic peptide, total cholesterol （ OR = 3. 523, P = 0. 007 ） and high density lipoprotein cholesterol （ OR = 0. 205, P = 0. 041 ） were associated with depression in CHF patients. Conclusion Total cholesterol can increase the risk of depression, and high density lipoprotein cholesterol can reduce the risk of depression in CHF patients.