慢性心力衰竭患者并发抑郁障碍的影响因素及对患者UA、CysC、Scr、生活质量及预后的影响

Influencing Factors of Patients with Chronic Heart Failure Complicated with Depression Disorder and Their Effects on UA, CysC, Scr, Quality of Life and Prognosis

目的:探讨慢性心力衰竭(CHF)患者并发抑郁障碍的影响因素,并分析其对患者血清尿酸(UA)、胱抑素C(Cys C)、血肌酐(Scr)、生活质量及预后的影响。方法:选取2019年4月~2021年3月我院收治的106例CHF患者作为研究对象。采用汉密尔顿抑郁量表(HAMD)评估所有患者的抑郁情况,根据评估结果将患者分为抑郁组和未抑郁组。收集临床资料,采用多因素Logistic回归分析CHF患者并发抑郁障碍的影响因素。检测并对比两组患者血清UA、Cys C、Scr水平差异。比较两组患者明尼苏达心力衰竭生活质量量表(MLHFQ)评分差异。随访半年,比较两组患者预后不良事件的发生率。结果:106例CHF患者中,有21例患者HAMD评分≥8分,抑郁障碍的发生率为19.81%。抑郁组和未抑郁组在性别、年龄、心电图结果是否异常、是否发生房颤、NYHA心功能分级、住院天数方面对比差异有统计学意义(P<0.05)。进一步多因素Logistic回归分析显示:女性、年龄≥65岁、发生房颤、住院天数≥10 d是CHF患者并发抑郁的危险因素(P<0.05)。抑郁组血清UA、Cys C、Scr水平均高于未抑郁组(P<0.05)。抑郁组MLHFQ各领域(躯体领域、其他领域、情绪领域)评分及总分均高于未抑郁组(P<0.05)。抑郁组的预后不良事件发生率高于未抑郁组(P<0.05)。结论:CHF患者中并发抑郁的比例较高,其发生受到住院天数、房颤、性别、年龄等因素影响,抑郁使CHF患者的生活质量明显降低,血清UA、Cys C、Scr水平呈高表达,且预后相对更差,需引起临床重视。

Objective: To investigate the influencing factors of patients with chronic heart failure(CHF) complicated with depression disorder, and to analyze the effects on serum uric acid(UA), Cystatin C(Cys C), serum creatinine(SCR), quality of life and prognosis. Methods: A total of 106 patients with CHF who were admitted to our hospital from April 2019 to March 2021 were selected as the study subjects. Hamilton Depression Scale(HAMD) was used to evaluate the depression of all patients, and they were divided into depression group and non-depression group. The clinical data were collected, and the influencing factors of patients with CHF complicated with depression disorder were analyzed by multivariate Logistic regression. The levels of serum UA, Cys C and SCR were detected and compared between the two groups. The differences of Minnesota Heart Failure Quality of life scale(MLHFQ) scores were compared between the two groups. The incidence of adverse prognostic events in the two groups were compared at 6 months after follow-up. Results:Among 106 patients with CHF, 21 patients had HAMD score ≥8 scores, and the incidence of depression disorder was 19.81%. There were statistically significant differences between the depression group and non-depression group in gender, age, whether ECG results abnormal, whether atrial fibrillation occur, NYHA cardiac function grade and hospital stay(P<0.05). Further multivariate Logistic regression analysis showed that female, age ≥65 years, atrial fibrillation occur and hospital stay ≥10d were risk factors for depression in patients with CHF(P<0.05). The levels of serum UA, Cys C and Scr in depression group were higher than those in non-depression group(P<0.05).The scores and total scores of MLHFQ in various fields(somatic domain, other domain and emotional domain) in depression group were higher than those in non-depression group(P<0.05). The incidence of adverse prognostic events in depression group was higher than that in non-depression group(P<0.05). Conclusion: The proportion of patients with CHF with depression is high, which is affected by the hospital stay, atrial fibrillation, gender, age and other factors. The quality of life of patients with CHF with depression is significantly reduced, the serum UA, Cys C, Scr levels are highly expressed, and the prognosis is relatively worse, which needs clinical attention.