经皮冠状动脉介入治疗老年患者焦虑、抑郁情绪与睡眠质量及生活质量的相关性

Correlation of anxiety and depression with sleep quality and quality of life in elderly patients with percutaneous coronary intervention

目的·探讨接受经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的老年患者焦虑、抑郁情绪与睡眠质量及生活质量的相关性。方法·选取在上海交通大学医学院附属新华医院和上海交通大学附属第六人民医院住院行PCI术的297例老年患者为研究对象,采用一般资料调查表、综合医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)、匹兹堡睡眠质量指数量表(Piusburgh sleep quality index,PSQI)和健康调查量表(12-item short form health survey version 2.0,SF-12v2)对其在出院前1日进行问卷调查,3份量表均回顾性调研入院前1个月的主观感受。对焦虑、抑郁得分与睡眠质量和生活质量得分做Spearman相关分析,生活质量影响因素的分析采用多元线性回归法。结果·PCI老年患者中21.5%被评估为焦虑阳性,22.2%被评估为抑郁阳性,高于国内综合医院就诊患者的焦虑、抑郁水平(均P=0.000)。患者睡眠质量总分的平均分为(6.50±3.46)分,高于国内常模水平(P=0.000)。患者生活质量总分的平均分为(132.20±30.83)分,生理总评分均分为(60.44±17.58)分,心理总评分均分为(71.76±15.96)分。相关性分析表明,焦虑、抑郁评分与睡眠质量总分均呈正相关(P=0.026,P=0.027),与生活质量总分及生理总评分和心理总评分均呈负相关(均P=0.000)。PCI老年患者焦虑、抑郁评分与生活质量得分的线性回归方程有意义(P=0.000,R^2=0.246)。结论·PCI老年患者最近1个月的焦虑、抑郁情绪发生率高,睡眠情况差。焦虑或抑郁情绪越明显,睡眠质量和生活质量越差。应重视焦虑、抑郁情绪与睡眠质量和生活质量的相关性,改善患者的负性情绪,提高其睡眠质量和生活质量。

Objective·To explore the correlation of anxiety and depression with sleep quality and quality of life in elderly patients with percutaneous coronary intervention(PCI).Methods·A total of 297 elderly patients undergoing PCI were surveyed according to hospital anxiety and depression scale(HADS),Piusburgh sleep quality index(PSQI)and 12-item short form health survey version 2.0(SF-12v2)on the day before they were discharged from two hospitals(Xinhua Hospital,Shanghai Jiao Tong University School of Medicine and Shanghai Sixth People's Hospital,Shanghai Jiao Tong University).All data was based on their subjective feelings in the past month.Spearman correlation analysis was performed on the scores of anxiety and depression to sleep quality and life quality.The multiple linear regression was used to analyze the influencing factors of life quality.Results·21.5%of the patients were assessed as anxiety positive,and 22.2%were assessed as depression positive,both higher than those of the patients in general hospitals of China(both P=0.000).The average score of patients'sleep quality was 6.50±3.46,which was higher than the domestic norm(P=0.000).The average score of patients'quality of life was 132.20±30.83,the physiological score was 60.44±17.58,and the psychological score was 71.76±15.96.Correlation analysis showed that there was a significant positive correlation between total scores of anxiety and depression and total scores of sleep quality(P=0.026,P=0.027),and a significant negative correlation between total scores of anxiety and depression and total quality of life scores,the physiological scores and the psychological scores(all P=0.000).The linear regression equation of anxiety and depression scores and quality of life scores in elderly patients with PCI was significant(P=0.000,R2=0.246).Conclusion·The incidence of anxiety and depression in elderly PCI patients was high in the last month before admission,and the sleep was poor.The more obvious the anxiety or depression,the worse the quality of sleep and quality of life.Attention should be paid to the relations of anxiety and depression to sleep quality and quality of life,and efforts should be made to improve the negative emotions of patients and enhance their sleep quality and quality of life.