老年急性非ST段抬高型心肌梗死患者精神心理现状分析

Mental and psychological status in elderly patients with acute non-ST segment elevation myocardial infarction

目的探讨老年急性非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)患者合并抑郁、压力和焦虑的相关危险因素。方法选取首都医科大学附属北京安贞医院2021年5月至2022年5月急诊危重症中心急性NSTEMI患者268例作为研究对象,按年龄分为中青年组127例,年龄(48.9±8.6)岁,老年组141例,年龄(67.8±5.7)岁。选择情绪自评量表/抑郁-焦虑-压力量表(Depression-Anxiety-Stress Scale,DASS-21)进行评价,通过二元logistics回归分析及χ~2检验分析患者抑郁、压力和焦虑的相关因素。结果中青年组与老年组NSTEMI患者合并抑郁、压力、焦虑比例以及DASS-21平均评分抑郁、压力、焦虑比较,无统计学差异(P>0.05)。二元logistics回归分析显示,老年组NSTEMI患者合并抑郁与女性、高胆固醇呈正相关(OR=4.653,95%CI:1.316~16.444,P=0.017;OR=3.181,95%CI:1.172~8.632,P=0.023),压力与女性、糖尿病史、高甘油三酯血症、高胆固醇血症及高胆固醇史呈正相关(OR=13.361,95%CI:2.237~79.805,P=0.004;OR=7.784,95%CI:1.632~37.118,P=0.010;OR=6.190,95%CI:1.084~35.333,P=0.040;OR=7.383,95%CI:1.481~36.805,P=0.015;OR=10.278,95%CI:1.194~88.493,P=0.034),焦虑与女性、高体质量指数、糖尿病史、高胆固醇史呈正相关(OR=4.805,95%CI:1.149~20.093,P=0.032;OR=1.217,95%CI:1.008~1.470,P=0.041;OR=4.092,95%CI:1.215~13.783,P=0.023;OR=4.128,95%CI:1.077~15.821,P=0.039)。结论中青年组与老年组NSTEMI患者合并抑郁、压力及焦虑三者存在相关性。老年组NSTEMI患者合并抑郁、压力及焦虑与女性、高胆固醇血症呈正相关。

Objective To investigate the related risk factors of depression,stress and anxiety in the elderly patients with acute non-ST-segment elevation myocardial infarction(NSTEMI).MethodsA total of 268 patients with acute NSTEMI admitted in the Emergency Critical Care Center of Beijing Anzhen Hospital from May 2021 to May 2022 were selected as the research subjects,and divided into young and middle-aged group(n=127)and elderly group(n=141)according to their age.Emotional Self-Rating Scale/Depression-Anxiety-Stress Scale(DASS-21)was used for evaluation,and the related factors of depression,stress and anxiety were analyzed by binary logistic regression analysis and Chi-square test.Results There were no significant differences in the proportions of depression,stress and anxiety and the mean DASS-21 score between the young and middle-aged group and the elderly group(P>0.05).Binary logistic regression analysis showed that depression in the elderly NSTEMI patients was positively correlated with female and high cholesterol level(OR=4.653,95%CI:1.316-16.444,P=0.017;OR=3.181,95%CI:1.172-8.632,P=0.023),stress was positively correlated with female,history of diabetes,hypertriglyceridemia,hypercholesterolemia and history of hypercholesterolemia(OR=13.361,95%CI:2.237-79.805,P=0.004;OR=7.784,95%CI:1.632-37.118,P=0.010;OR=6.190,95%CI:1.084-35.333,P=0.040;OR=7.383,95%CI:1.481-36.805,P=0.015;OR=10.278,95%CI:1.194-88.493,P=0.034),and anxiety was positively correlated with female,high BMI,history of diabetes,and high cholesterol(OR=4.805,95%CI:1.149-20.093,P=0.032;OR=1.217,95%CI:1.008-1.470,P=0.041;OR=4.092,95%CI:1.215-13.783,P=0.023;OR=4.128,95%CI:1.077-15.821,P=0.039).Conclusion Depression,stress and anxiety are correlated with each other in the young and middle-aged and elderly NSTEMI patients.These conditions are positively correlated with female and hypercholesterolemia in the elderly NSTEMI patients.