瑞舒伐他汀对老年冠心病病人抑郁评分的影响及抑郁的危险因素分析

Effect of rosuvastatin on depression score and the risk factors of depression in the elderly patients with coronary heart disease

目的探讨瑞舒伐他汀对老年CHD病人抑郁评分的影响,并分析抑郁的危险因素。方法将2017年8月至2019年8月我院收治的72例老年CHD合并抑郁病人随机分为A、B组,每组各36例,另选取同期我院收治的150例老年CHD未合并抑郁病人作为对照组。3组病人均给予相同的基础治疗,A组另给予瑞舒伐他汀治疗,B组另给予阿托伐他汀治疗。对CHD病人治疗前后老年抑郁量表(GDS)评分进行比较,分析影响老年CHD合并抑郁状况的危险因素。结果治疗前,A、B 2组之间GDS评分比较差异无统计学意义(P>0.05)。治疗后,A、B 2组GDS评分均明显降低,且A组的GDS评分低于B组(P<0.05)。单因素分析结果提示年龄、性别、家庭收入、文化程度、睡眠状况、病程、社会支持得分、GDS评分均是影响CHD病人发生抑郁的主要因素(P<0.05);进一步Logistic回归分析显示年龄≥70岁、女性、睡眠状况差、GDS评分高、病程≥5年是老年CHD病人发生抑郁的危险因素,家庭收入高和多社会支持是其保护性因素。结论瑞舒伐他汀能有效改善老年CHD病人的抑郁状况;年龄、性别、睡眠状况、家庭收入、病程、社会支持和GDS评分与老年CHD病人并发抑郁的关系密切。

Objective To investigate the effect of rosuvastatin on depression score and to analyze the risk factors for depression in the elderly patients with coronary heart disease(CHD).Methods Seventy-two elderly patients with CHD complicated with depression admitted to our hospital from August 2017 to August 2019 were enrolled.They were divided into group A and group B randomly,with 36 cases in each group.At the same time,150 elderly CHD patients without depression in our hospital were selected as the control group.All the patients were given the same routine treatment,and group A was treated with rosuvastatin and group B was treated with atorvastatin additionally.Geriatric Depression Scale(GDS)scores of group A and group B were compared before and after the treatment,and the risk factors of CHD complicated with depression in the elderly were analyzed.Results Before treatment,there was no statistically significant difference in GDS score between group A and group B(P>0.05).After treatment,the GDS scores in the two groups were significantly lower than those before treatment,especially in group A(P<0.05).Single factor analysis showed that age,gender,family income,education level,sleep status,disease course,social support score and GDS score were the main factors affecting the occurrence of depression in the patients with CHD(P<0.05).Further Logistic regression analysis showed that age≥70 years,woman,poor sleep quality,high GDS score,the course of disease≥5 years were the risk factors for depression in the elderly patients with CHD,while the high family income and social support were protective factors.Conclusions Rosuvastatin can effectively improve the depression of the elderly patients with CHD.Age,gender,sleep status,family income,disease course,social support score and GDS score were closely correlated with depression in the elderly patients with CHD.