经皮冠状动脉介入术后患者抑郁的影响因素分析

Analysis of Influencing Factors for Depression after PCI in Patients with Coronary Heart Disease

目的探讨冠心病患者接受经皮冠状动脉介入(PCI)治疗后出现抑郁的影响因素。方法选择2016年1月至2019年12月在江苏省海安市人民医院接受PCI后随访治疗的冠心病患者684例。根据患者健康问卷9项(PHQ-9)评分,将患者PCI术后并发抑郁者纳入抑郁组(n=154),PCI术后无抑郁者纳入非抑郁组(n=530)。收集并用Logistic回归分析两组患者的人口学资料和临床病史资料。结果抑郁组患者PCI术后1年再次血运重建的比例高于非抑郁组(P=0.035)。多元Logistic回归分析显示,D型人格、既往PCI或冠状动脉旁路移植(CABG)史、糖尿病和小学及以下教育程度是患者PCI术后1年发生抑郁的危险因素(P均<0.05),分别使患者发生抑郁的风险增加4.259倍、3.623倍、2.572倍和1.86倍。结论D型人格、既往PCI或CABG史、糖尿病和小学及以下教育程度是冠心病患者PCI术后发生抑郁的影响因素。

Objective To investigate the risk factors for depression after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CAD).Methods From January 2016 to December 2019,total 684 patients with CAD who underwent follow-up after PCI were enrolled in our hospital.According to the 9 scores of the health questionnaire,patients were divided into post-PCI depression group(depression group,n=154)and post-PCI no depression group(non-depression group,n=530).The demographic data and clinical history data of the two groups were collected and analyzed by Logistic regression analysis.Results The rate of revascularization in the depression group was significantly higher than that of the non-depression group at 1 year after PCI(P=0.035).Multivariate logistic regression analysis showed that type D personality,a history of PCI or coronary artery bypass graft(CABG),diabetes,and an education level of elementary school and below were the risk factors for depression at 1 year after PCI(P all<0.05),which increased the risk of depression by 4.259 times,3.623 times,2.572 times and 1.86 times respectively.Conclusion Type D personality,a history of PCI or CABG,diabetes,and primary education or below of education level are risk factors for depression after PCI in patients with CAD.PCI perioperative screening and intervention of depression can improve the prognosis of patients.