绝经后女性PCI术后抑郁状态对临床预后的影响

Prognostic impact of depression in postmenopausal women received PCI

目的评价绝经后女性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）术后抑郁状态的发生率及其对预后的影响。方法入选2013年1月~2014年12月于陆军总医院心血管疾病研究所就诊，经冠状动脉造影证实为冠心病并接受PCI治疗的65岁以上绝经女性患者277例，同时入选冠心病行PCI治疗的65岁以上男性患者277例作为对照组。所有入选患者均于入院后接受汉密尔顿抑郁量表评估，除外抑郁状态，并与PCI术后1月时再次接受汉密尔顿抑郁量表评估对其抑郁情况进行调查，对新发抑郁的发生率进行统计。女性患者随访12个月，比较抑郁及非抑郁患者不良事件的发生率。结果女性患者PCI术后抑郁发生率显著高于男性（35%vs.15.2%，P＜0.001）。随访12个月，女性抑郁患者不良事件发生率显著高于女性非抑郁患者（16.5%vs.7.2%，P=0.015）。结论绝经后女性冠心病患者PCI术后抑郁发生率显著高于男性患者。抑郁状态可显著增加绝经后女性冠心病患者PCI术后12月不良事件发生率。

Objective To evaluate the depression rate and its prognostic impact for the postmenopausal womenwith coronary artery disease(CAD) and received Percutaneous Coronary Intervention (PCI). Methods A total 277postmenopausal women with CAD and received PCI in General hospital of Beijing Command of PLA were enrolledbetween January 2013 and December 2014. 277 male patients with CAD and received PCI were also enrolled ascontrol group during the same period. Table HAMD were applied for all the patients to evaluate the depressionstatus 1 month after PCI. 12 months’ follow-up was performed to evaluate the prognostic impact of depressionfor postmenopausal women. Results Female patients had higher depression rate than male patients after PCI (35%vs. 15.2%, P<0.001). With 12 months follow-up, adverse events rate was much higher in female patients withdepression than those without depression(16.5% vs. 7.2%,P=0.015). Conclusion Depression rate was much higherin postmenopausal women than in male patients who have CAD and received PCI. Depression could increase 12months’ adverse event rate after PCI for the postmenopausal women CAD patients.