冠状动脉慢血流与焦虑抑郁关系的研究

Relationship between coronary artery slow flow and anxiety as well as depression

目的探讨冠状动脉慢血流与焦虑抑郁的关系。方法入选2017年1月至2018年8月因不典型胸痛行冠状动脉造影而冠脉无明显狭窄病变的100例患者为研究对象,记录患者一般临床资料、超声心动图结果并于入院第2天行汉密顿焦虑、抑郁量表评分;将校正的实测TIMI帧数大于正常冠状动脉血流速度2个标准差者定义为冠状动脉慢血流,据此将其分为慢血流组(n=63)例和正常血流组(n=37)例;观察2组同型半胱氨酸和高敏C-反应蛋白水平。结果 2组性别比、高血压、糖尿病、血脂、吸烟等一般冠心病危险因素,差异无统计学意义(P>0.05);与正常对照组比较慢血流组汉密顿焦虑、抑郁量表评分显著升高,差异有统计学意义(10.61±4.48,6.12±1.82;7.49±1.99,5.55±1.44;P<0.001),且焦虑抑郁评分与TIMI血流帧数呈正相关;与正常对照组比较,慢血流组同型半胱氨酸和高敏C-反应蛋白水平显著升高(21.17±8.65,11.15±5.42;2.82±1.01,1.86±0.57;P<0.01)。结论慢血流患者焦虑抑郁评分较冠脉血流正常组明显升高,差异有统计学意义(P<0.01),且独立于冠心病危险因素,同时慢血流患者同型半胱氨酸和高敏C-反应蛋白水平显著升高。

Objective To explore the relationship between coronary artery slow flow and anxiety as well as depression.Methods One hundred patients without obvious coronary artery stenosis who underwent coronary angiography due to atypical chest pain in our hospital from January 2017 to August 2018 were enrolled in the study. The general clinical data and echocardiographic results were recorded, and scores for Hamilton anxiety scale(HAMA) and Hamilton depression scale(HAMD) were obtained on the second day of admission. That the corrected TIMI frame count was greater than the standard coronary blood flow velocity by 2 standard deviation was defined as coronary slow flow, according to which they were divided into slow flow group(n=63) and control group(n=37). Homocysteine and high-sensitivity C-reactive protein(hs-CRP) levels in both groups were observed.Results There were no significant differences in general risk factors for coronary heart disease(CHD), including gender, hypertension, diabetes, blood lipids and smoking between the two groups(P>0.05). As compared with those in normal control group, scores for HAMA and HAMD in slow flow group were significantly higher than those in control group(10.61±4.48 vs 6.12±1.82;7.49±1.99 vs 5.55±1.44,P<0.01). In addition, the HAMA and HAMD scores were positively correlated with TIMI frame count. As compared with those in control group, the levels of homocysteine and hs CPR in slow flow group were significantly increased(21.17±8.65 vs 11.15±5.42;2.82±1.01 vs 1.86±0.57,P<0.01).Conclusion HAMA and HAMD scores in patients with coronary artery slow blood flow are significantly higher than those with normal coronary artery blood flow,moreover, which are independent of risk factors for CHD. In addition, homocysteine and hs-CRP levels are significantly increased in the patients with coronary artery slow blood flow.