经皮冠状动脉介入治疗对冠心病患者术后焦虑和抑郁影响的研究

Impact on anxiety and depression among patients with coronary heart disease after percutaneous coronary intervention

目的评价经皮冠状动脉介入治疗对冠心病患者术后焦虑和抑郁影响。方法600例冠心病患者根据是否在冠状动脉造影时接受支架植入术治疗分为支架组(n=400)和非支架组(n=200),400例支架组患者根据术后是否接受心理干预治疗进一步随机分成干预组(n=200)和非干预组(n=200)。患者入院后1 d、PCI治疗后1 d、出院时分别采用焦虑自我量表和抑郁自我量表进行焦虑和抑郁评分,比较不同时间患者焦虑和抑郁评分。结果3组患者平均年龄、性别构成、血红蛋白含量、总胆固醇含量、甘油三酯含量、低密度脂蛋白胆固醇含量和高密度脂蛋白胆固醇含量差异均无统计学意义(均P>0.05),具有可比性。入院后1 d,3组冠心病患者焦虑和抑郁评分差异均无统计学意义(均P>0.05);PCI治疗后1 d,干预组和非干预组冠心病患者焦虑和抑郁评分均显著高于非支架组(均P<0.05),干预组和非干预组冠心病患者焦虑(t=11.21,P<0.01;t=9.96,P<0.01)和抑郁评分(t=8.56,P<0.01;t=6.73,P<0.01)均显著高于入院后1 d。出院时,3组冠心病患者焦虑和抑郁评分差异均有统计学意义(均P<0.05),干预组和非干预组冠心病患者出院时焦虑(t=21.57,P<0.01;t=15.77,P<0.01)和抑郁评分(t=24.33,P<0.01;t=15.01,P<0.01)均显著低于PCI治疗后1 d,干预组焦虑和抑郁评分均显著低于非干预组(均P<0.05)。结论PCI治疗会加重冠心病患者术后焦虑和抑郁状态,而心理干预治疗可减轻焦虑和抑郁状态。

Objective To evaluate the effect of percutaneous coronary intervention(PCI)on anxiety and depression among patients with coronary heart disease(CHD).Methods A total of 600 CHD patients were divided into the stent group(n=400)and the non-stent group(n=200)according to stent implantation during coronary angiography,and 400 cases in the stent group were further divided into the intervention group(n=200)and the non-intervention group(n=200)according to post-stenting psychological interventions.The anxiety and depression were scored using self-rating anxiety and depression scales 1 day after admission,1 day after PCI and at discharge from hospital,and the anxiety and depression scores were compared at different time points.Results The mean age,sex ratio,hemoglobin,total cholesterol,triglyceride,highdensity lipoprotein cholesteroland low-density lipoprotein cholesterol levels were comparable among the three groups(P>0.05).There were no significant differences among the three groups in terms of anxiety or depression scores one day after admission(P>0.05).One day after PCI,the anxiety and depression scores were significantly higher among CHD patients in the intervention and non-intervention groups than in the non-stent group(P<0.05),and the anxiety(t=11.21,P<0.01;t=9.96,P<0.01)and depression scores(t=8.56,P<0.01;t=6.73,P<0.01)were significantly higher in the intervention and non-intervention groups one day after PCI than one day after admission.At discharge from hospital,there were significant differences among the three groups in terms of anxiety and depression scores(P<0.05),and the anxiety(t=21.57,P<0.01;t=15.77,P<0.01)and depression scores(t=24.33,P<0.01;t=15.01,P<0.01)were significantly higher in the intervention and non-intervention groups at discharge from hospital than one day after PCI,while the anxiety and depression scores were significantly lower among CHD patients in the intervention group than in the non-intervention group(P<0.05).Conclusion The anxiety and depression are aggravated among CHD patients after PCI,and psychological interventions may alleviate the anxiety and depression.