焦虑抑郁对急性心肌梗死PCI术后患者hs-CRP、hs-cTnT、住院时间及近期预后的影响

Effect of Anxiety and Depression on hs-CRP,hs-cTnT,Length of Hospital Stay and Short-Term Prognosis in Patients with Acute Myocardial Infarction after PCI

目的:探讨焦虑抑郁对急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)后患者血清超敏c-反应蛋白(hs-CRP)、超敏肌钙蛋白T(hs-cTnT)、住院时间及近期预后的影响。方法:选取行急诊PCI术后的急性ST段抬高型心肌梗死(STEMI)患者160例,于术后第2天采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者进行评分,根据评分分为焦虑抑郁组(n=41,有焦虑且有抑郁)、焦虑组(n=33,有焦虑但无抑郁)、抑郁组(n=40,无焦虑但有抑郁)及对照组(n=46,无焦虑且无抑郁);于术后第2天清晨抽取4组患者空腹外周静脉血,采用颗粒增强免疫透射比浊法检测血清hs-CRP水平,采用电化学发光法检测血清hs-cTnT水平;于入院后24 h内收集4组患者一般临床特征资料,并统计住院时间;于手术后1个月内对4组患者进行随访,记录主要心血管不良事件(MACE)的发生情况。结果:焦虑抑郁组、焦虑组及抑郁组患者血清hs-CRP水平高于对照组,差异有统计学意义(P<0.05);焦虑抑郁组患者MACE发生率高于对照组,差异有统计学意义(P<0.05)。结论:焦虑抑郁情绪会增加急性心肌梗死PCI术后患者血清hs-CRP水平和术后1个月内MACE的发生,但对患者血清hs-cTnT水平及住院时间无明显影响。

Objective:To investigate the effect of the anxiety and depression on serum hypersensitivity c-reactive protein(hs-CRP),hypersensitivity troponin T(hs-cTnT),the length of hospital stay and short-term prognosis of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:One hundred and sixty patients with acute ST-segment elevation myocardial infarction(STEMI)after emergent PCI were selected.On the second day after PCI,these patients were evaluated to score the self-assessment scale for anxiety(SAS)and self-assessment scale for depression(SDS).Based on their SAS and SDS scores,these patients were divided into 4 groups:anxiety and depression group(n=41,anxiety and depression),anxiety group(n=33,only anxiety but no depression),depression group(n=40,no anxiety but depression)and Control group(n=46,no anxiety and no depression).Fasting peripheral venous blood was drawn from these patients in the early morning of the second day after PCI.Serum hs-CRP level was detected by particle-enhanced turbidimetric immunoassay(PETIA),and electrochemiluminescence method was used to detect serum hs-cTnT levels.The general clinical characteristics of these patients were collected within 24 hours after the admission,and the hospital stay was counted.These patients were followed up within 1 month after surgery to record the major cardiovascular adverse events(MACE).Results:The levels of serum hs-CRP were higher in the anxiety and depression group,the anxiety group and the depression group than those in the control group(P<0.05).The incidence of MACE was higher in the anxiety and depression group than that in the control group(P<0.05).Conclusion:Anxiety and depression can increase the serum hs-CRP level and the incidence of MACE in patients with AMI after PCI,but it has no significant effect on the serum hs-cTnT level and hospital stay.