体外循环心脏瓣膜置换术患者术后抑郁的危险因素分析

Analysis of risk factors for postoperative depression in patients undergoing extracorporeal circulation heart valve replacement surgery

目的分析体外循环(Cardiopulmonary Bypass,CPB)心脏瓣膜置换术患者术后抑郁的危险因素。方法选取我院2020年1月~2022年12月进行CPB下心脏瓣膜置换术的80例患者纳入研究。于患者术后第3 d根据抑郁自评量表(SDS)评分分为未发生抑郁组(SDS评分≥53分)48例及发生组(SDS评分<53分)32例。比较两组患者相关基线资料,检测各组谷氨酸(Glutamic Acid,Glu)及γ-氨基丁酸(γ-Aminobutyric Acid,GABA)浓度并比较,通过ROC及经多因素Logistic回归分析Glu、GABA水平预测抑郁的价值。结果两组患者相关基线资料比较无显著差异(P>0.05),发生组Glu、GABA均高于未发生组(P<0.05);与正常组比较,发生组T1-T4时点血浆Glu、GABA浓度显著升高(P<0.05);经ROC及经多因素Logistic回归分析,证实Glu>27.833、GABA>174.684是发生抑郁的危险因素,可用于抑郁的预测,曲线下面积分别为0.957、0.711(P<0.05)。结论血浆Glu、GABA浓度升高可能参与了抑郁发生的病理生理过程,可为临床检测抑郁提供参考依据。

Objective To investigate the risk factors of postoperative depression in patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass(CPB).Methods 80 patients who underwent cardiac valve replacement surgery under CPB in our hospital from January 2020 to December 2022 were selected for the study.On the third day after surgery,the patient was divided into a non-occurring group(SDS score≥53)of 48 cases and an occurring group(SDS score<53)of 32 cases based on the Self Rating Depression Scale(SDS)score.Compare the baseline data of two groups of patients,and measure the levels of glutamate acid(Glu)in each groupγ-Aminobutyric acid(GABA)and predict the value of Clu and GABA levels in predicting depression through ROC and multivariate logistic regression analysis.Results There was no significant difference in baseline data between the two groups of patients(P>0.05),and Clu and GABA levels in the occurrence group were higher than those in the non-occurrence group(P<0.05);Compared with the normal group,the plasma Glu and GABA concentrations in the occurrence group at T1-T4 time points were significantly increased(P<0.05);Through ROC and multivariate logistic regression analysis,it was confirmed that Glu>27.833 and GABA>174.684 are risk factors affecting depression,which can be used for predicting depression.The area under the curve is 0.957 and 0.711,respectively(P<0.05).Conclusion Elevated plasma Glu and GABA concentrations may be involved in the pathophysiological process of depression,providing reliable reference for clinical detection of depression.