冠心病患者冠脉病变狭窄程度与抑郁情绪相关性分析

Correlation analysis of coronary artery stenosis degree and depression mood in patients with coronary heart disease

目的探讨冠心病患者冠脉病变狭窄程度与抑郁情绪的相关性。方法选取2019年4月—12月于广西医科大学第一附属医院就诊的223例冠心病患者作为研究对象,根据抑郁自评量表(SDS)评分分为非抑郁组(162例,SDS指数<50分)、抑郁组(61例,SDS指数≥50分),其中抑郁组分为轻度抑郁组(49例,50分≤SDS指数<60分)和中重度抑郁组(12例,SDS指数≥60分)。根据冠脉造影结果,用Gensini评分评价冠脉病变狭窄程度。采用多因素logistic回归分析冠脉病变狭窄程度与抑郁的关系。结果抑郁组女性、单身、D型人格患者比例及年龄、匹兹堡睡眠质量指数(PSQI)评分、Gensini评分、红细胞分布宽度变异系数(RDW-CV)水平高于非抑郁组,红细胞计数、血红蛋白水平低于非抑郁组,差异均有统计学意义(均P<0.05);中重度抑郁组体重指数、PSQI评分、RDW-CV水平高于轻度抑郁组,差异均有统计意义(均P<0.05)。以是否发生抑郁为因变量进行二元logistic回归分析,结果显示:单身[OR=5.31,95%CI(1.54~18.35)]、D型人格[OR=5.67,95%CI(2.42~13.29)]、PSQI评分[OR=1.40,95%CI(1.24~1.58)]、RDW-CV[OR=2.07,95%CI(1.30~3.32)]和Gensini评分是患者抑郁发生的独立影响因素(均P<0.05),其中Gensini评分每增高10分,患者抑郁发生风险增高13%(95%CI:1.02~1.25,P=0.019)。以无、轻度、中重度抑郁为因变量进行有序多分类logistic回归分析,结果显示:单身[OR=5.07,95%CI(1.65~15.57)]、D型人格[OR=5.04,95%CI(2.25~11.31)]、PSQI评分[OR=1.46,95%CI(1.30~1.63)]、RDW-CV[OR=2.55,95%CI(1.64~3.95)]和Gensini评分是患者抑郁发生的独立影响因素(均P<0.05),其中Gensini评分每增高10分,患者抑郁发生风险增高12%(95%CI:1.02~1.23,P=0.020)。结论冠脉病变越重的冠心病患者更易同时伴有抑郁,应及时对该部分人群进行心理卫生评估。

Objective To investigate the correlation between the degree of coronary artery stenosis and depression mood in patients with coronary heart disease.Methods A total of 223 patients with coronary heart disease treated in the First Affiliated Hospital of Guangxi Medical University from April to December 2019 were selected as the research subjects.According to the self-rating depression scale(SDS)score,they were divided into non-depressed group(162 cases,SDS index<50 points)and depressed group(61 cases,SDS index≥50 points).The depressive group was divided into mild depression group(49 cases,50 points≤SDS index<60 points)and moderate and severe depression group(12 cases,SDS index≥60 points).According to the results of coronary angiography,the degree of coronary artery stenosis was evaluated by Gensini score.Multivariate logistic regression was used to analyze the relationship between the degree of coronary artery stenosis and depression.Results The proportion of female,single,type D personality in patients and age,Pittsburgh sleep quality index(PSQI)score,Gensini score,coefficient variation of red blood cell distribution width(RDW-CV)level in the depressed group were higher than those in the non-depressed group,red blood cell count and hemoglobin levels were lower than those in the non-depressed group,with statistically significant differences(all P<0.05).The levels of body mass index,PSQI score and RDW-CV level in moderate and severe depression group were higher than those in mild depression group,with statistically significant differences(all P<0.05).Binary logistic regression analysis was conducted with the occurrence of depression as the dependent variable,and the results showed that:single(OR=5.31,95%CI[1.54-18.35]),type D personality(OR=5.67,95%CI[2.42-13.29]),PSQI score(OR=1.40,95%CI[1.24-1.58]),RDW-CV(OR=2.07,95%CI[1.30-3.32])and Gensini score were independent influencing factors for the occurrence of depression(all P<0.05),in which the risk of depression increased by 13%for every 10 points increase in Gensini score(95%CI:1.02-1.25,P=0.019).Ordered multi-classification logistic regression analysis was conducted with nil,mild,moderate to severe depression as dependent variables,and the results showed that:single(OR=5.07,95%CI[1.65-15.57]),type D personality(OR=5.04,95%CI[2.25-11.31]),PSQI score(OR=1.46,95%CI[1.30-1.63]),RDW-CV(OR=2.55,95%CI[1.64-3.95])and Gensini score were independent influencing factors for the occurrence of depression(all P<0.05),in which the risk of depression increased by 12%for every 10 points increase in Gensini score(95%CI:1.02-1.23,P=0.020).Conclusion Patients with coronary heart disease with more severe coronary artery lesions are more likely to be accompanied by depression,so mental health assessment should be carried out in time for this part of the population.