经皮冠状动脉介入治疗对老年冠状动脉粥样硬化性心脏病患者焦虑和抑郁及生活质量的影响分析

Effect of percutaneous coronary intervention on anxiety,depression and quality of life in elderly patients with coronary atherosclerotic heart disease

目的分析经皮冠状动脉介入治疗对老年冠状动脉粥样硬化性心脏病患者焦虑和抑郁及生活质量的影响。方法选取2015年8月至2016年8月河北省廊坊市人民医院收治的行经皮冠状动脉介入(PCI)治疗的老年冠心病患者350例为研究对象。分析治疗前1周、治疗后3和6个月以及1年后的心功能指标[左心室射血分数(LVEF)、室壁运动积分指数(WMSI)和左心室短轴缩短率(FS)]、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、生活质量评分变化,检测血清中白细胞介素2(IL-2)及C反应蛋白(CRP)水平的变化。结果与PCI治疗前相比,患者经治疗后LVEF及FS明显升高,而WMSI明显降低;治疗后SAS和SDS评分明显降低[SAS评分:治疗后3个月(50±6)分、治疗后6个月(45±5)分、治疗后1年(42±4)分比治疗前1周(57±8)分;SDS评分:治疗后3个月(51±6)分、治疗后6个月(46±6)分、治疗后1年(40±4)分比治疗前1周(60±6)分],各项生活质量评分(心理领域评分、独立性领域评分、社会关系领域评分、环境领域评分、生理领域评分)均明显升高;治疗后血清IL-2和CRP水平明显降低,差异均有统计学意义(均P<0.05);且随着时间的延长上述指标的变化愈加明显。结论PCI治疗可有效改善老年冠心病患者的心功能,术后患者焦虑、抑郁及生活质量逐渐改善,此过程可能与血清中IL-2及CRP水平的恢复有关。

Objective To investigate the effect of percutaneous coronary intervention(PCI)on anxiety,depression and quality of life in elderly patients with coronary atherosclerotic heart disease(CHD).Methods A total of 350 elderly patients with CHD undergoing PCI from August 2015 to August 2016 in Langfang People′s Hospital,Hebei Province were enrolled.Cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular wall motion score index(WMSI)and left ventricular fraction shortening(FS)],scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS),quality of life scores,serum levels of interleukin-2(IL-2)and C-reactive protein(CRP)were analyzed 1 week before,3 months,6 months and 1 year after treatment.Results As the time is prolonging after PCI,LVEF and FS gradually increased and WMSI decreased;SAS and SDS scores decreased[SAS:(50±6)for 3 months,(45±5)for 6 months,(42±4)for 1 year after treatment vs(57±8)for 1 month before treatment;SDS:(51±6)for 3 months,(46±6)for 6 months,(40±4)for 1 year after treatment vs(60±6)for 1 month before treatment];quality of life scores(psychology,independence,social relation,environment and physiology)increased;serum levels of IL-2 and CRP decreased after treatment(all P<0.05).Conclusion PCI treating elderly patients with CHD can effectively improve cardiac function,relieve anxiety and depression and improve quality of life,which may be related to the recovery effect on serum IL-2 and CRP levels.