慢性心力衰竭伴发焦虑抑郁对患者血清5-HT、尿酸、胱抑素C和AngⅡ水平的影响

Effects of anxiety and depression in patients with chronic heart failure on serum levels of 5-HT,UA,cystatin C and AngⅡ

目的研究慢性心力衰竭伴发焦虑抑郁对患者血清5-羟色胺(5-HT)、尿酸、胱抑素C和血管紧张素Ⅱ(AngⅡ)水平的影响。方法回顾性选取2020年9月至2022年9月右江民族医学院附属医院收治的120例CHF患者作为研究对象。根据汉密尔顿焦虑量表(HAMA)(大于7分为焦虑)、汉密尔顿抑郁量表(HAMD)(≥7分为抑郁)分数将患者分为焦虑抑郁组(n=42)和非焦虑抑郁组(n=78)。焦虑抑郁组患者42例,非焦虑抑郁组患者78例。比较两组患者的5-HT、尿酸、胱抑素C、AngⅡ、血肌酐、一般自我效能感量表(GSES)评分、纽芬兰纪念大学幸福度量表(MUNSH)评分、并发症情况、生活质量。结果焦虑抑郁组患者5-HT低于非焦虑抑郁组,尿酸、胱抑素C、血肌酐水平均高于非焦虑抑郁组,差异均有统计学意义(P<0.05);两组患者AngⅡ比较,差异无统计学意义(P>0.05)。焦虑抑郁组患者GSES评分、MUNSH评分均低于非焦虑抑郁组,差异均有统计学意义(P<0.05)。焦虑抑郁组并发症总发生率为42.86%,明显高于非焦虑抑郁组(16.67%),差异有统计学意义(P<0.05)。焦虑抑郁组患者躯体供能、社会功能、心理功能、物质功能、生存质量总评分均显著低于非焦虑抑郁组,差异均有统计学意义(P<0.05)。结论慢性心力衰竭伴发焦虑抑郁患者5-HT更低,尿酸、胱抑素C、并发症总发生率更高,幸福感和生活质量更低,在慢性心力衰竭患者治疗中应注意减少焦虑抑郁的发生。

Objective To study the effects of chronic heart failure with anxiety depression on 5-hydroxytryptamine(5-HT),uric acid,cystatin C and angiotensinⅡ(AngⅡ)levels.Methods A total of 120 CHF patients admitted to Youjiang Medical College for Nationalities Affiliated Hospital from September 2020 to September 2022 were retrospectively selected as the study subjects.They were divided into anxiety and depression groups(n=42)and non anxiety and depression groups(n=78)based on the Hamilton anxiety scale(HAMA)(scores greater than 7 indicate anxiety)and Hamilton depression scale(HAMD)(scores≥7 indicate depression).The 5-HT,uric acid,cystatin C,AngⅡ,blood creatinine,general self-efficacy scale(GSES)score,Newfoundland Memorial University Happiness Scale(MUNSH)score,complications,and quality of life of the two groups of patients were compared.Results The level of 5-HT in the anxiety and depression group was lower than that in the non anxiety and depression group,and the levels of uric acid,cystatin C,and blood creatinine were all higher than those in the non anxiety and depression group,the differences were statistically significant(P<0.05);there was no statistically significant difference in AngⅡbetween the two groups of patients(P>0.05).The GSES score and MUNSH score of patients in the anxiety and depression group were lower than those in the non anxiety and depression group,and the differences were statistically significant(P<0.05).The total incidence of complications in the anxiety and depression group was 42.86%,which was significantly higher than that in the non anxiety and depression group(16.67%),the difference was statistically significant(P<0.05).The total scores of physical energy supply,social function,psychological function,material function,and quality of life in the anxiety and depression group were significantly lower than those in the non anxiety and depression group,the differences were statistically significant(P<0.05).Conclusion Chronic heart failure with anxiety and depression have lower 5-HT,uric acid,CysC,higher overall incidence of complications,and lower happiness and quality of life.Attention should be paid to reduce the occurrence of anxiety and depression in the treatment of patients with chronic heart failure.