焦虑抑郁情绪对冠心病患者心肺运动试验的影响

Effect of anxiety and depression on cardiopulmonary exercise test in patients with coronary artery disease

目的:比较冠心病、冠心病合并焦虑和/或抑郁患者的心肺运动试验(cardiopulmonary exercise test,CPET)的核心指标,探讨焦虑和/或抑郁情绪障碍对冠心病患者心肺功能及运动耐量的影响。方法:筛选255例稳定期冠心病患者及302例无冠心病者作为受试者,根据焦虑、抑郁量表结果将其分为对照组(n=96)、焦虑组(n=35)、抑郁组(n=36)、焦虑抑郁组(n=135)、冠心病组(n=91)、冠心病合并焦虑组(n=35)、冠心病合并抑郁组(n=34)、冠心病合并焦虑抑郁组(n=95),比较各组CPET核心指标的差异。结果:冠心病各组峰值摄氧量、无氧域、峰值代谢当量、峰值心率与对照组相比显著降低,而峰值收缩压、心率储备显著升高(均P<0.05);其中,冠心病合并焦虑抑郁组以上指标与冠心病组相比,差异均有统计学意义(均P<0.05);焦虑组、抑郁组、焦虑抑郁组与对照组相比,差异均无统计学意义(均P>0.05)。结论:焦虑合并抑郁的冠心病患者心肺功能及运动耐量下降显著;单纯焦虑或单纯抑郁的冠心病患者心肺功能及运动耐量有下降趋势。单纯焦虑、抑郁、焦虑合并抑郁并不会对非冠心病对照人群的心肺功能及运动耐量产生负性影响。

Objective:To compare the core indexes of cardiopulmonary exercise test(CPET)in thepatients with coronary artery disease and combining anxiety and/or depression,and toexplore the effect of the emotional disorder with“anxiety and/or depression”oncardiopulmonary function and exercise tolerance in patients with coronary artery disease.Methods:A total of 255 patients with stable coronary artery disease and 302 patientswithout coronary artery disease were selected as subjects.According to the results ofanxiety and depression scale,they were divided into a control group(n=96),an anxietygroup(n=35),a depression group(n=36),an anxiety and depression group(n=135),acoronary artery disease group(n=91),a coronary artery disease combined with anxietygroup(n=35),a coronary artery disease combined with depression group(n=34)and acoronary artery disease combined with anxiety and depression group(n=95).Thedifferences in the core indexes of CPET among the different groups were compared.Results:Peak oxygen uptake,anaerobic domain,peak metabolic equivalent,and peak heartrate in all coronary artery disease groups were significantly lower than those in the controlgroup,while peak systolic pressure and heart rate reserve were significantly increased(allP<0.05);among them,there were significantly difference in the above indexes between thecoronary artery disease combined with anxiety and depression group and the coronaryartery disease group(all P<0.05);there was no significant difference among the anxietygroup,the depression group,and the anxiety and depression group and the control group(all P>0.05).Conclusion:The cardiopulmonary function and exercise tolerance is significantlydecreased in the coronary artery disease combined with anxiety and depression patients;there is a declining trend in the cardiopulmonary function and exercise tolerance in thesimple anxiety or simple depression patients.Simple anxiety,simple depression and simpleanxiety combined with depression don’t cause a negative impact on cardiopulmonaryfunction and exercise tolerance in non-coronary artery disease control population.