冠状动脉介入术后患者抑郁障碍及其与预后的关系

被引：48

作者：

郭敏 ^{[1
,2
]}

史冬梅 ^{[1
]}

周玉杰 ^{[1
]}

姜明明 ^{[2
]}

王志坚 ^{[1
]}

机构：

[1] 首都医科大学附属北京安贞医院十二病房

[2] 延边大学医学部

来源：

中国介入心脏病学杂志 | 2010年 / 18卷 / 01期

关键词：

血管成形术,经腔,经皮冠状动脉; 抑郁症; 预后;

D O I：

暂无

中图分类号：

R749.2 [躯体疾病伴发精神障碍]; R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

100205 ; 1002 ; 100201 ;

摘要：

目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后冠心病患者抑郁障碍的患病率及其和临床预后的关系。方法采用24项汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)对400例PCI患者术前及术后2周分别进行抑郁障碍评分,根据术后2周的抑郁障碍评分分为抑郁组(HAMD≥21分)和非抑郁组(HAMD<21分),并于出院后对两组患者进行12个月的临床随访。随访终点为12个月内的主要不良心血管事件(major adverse cardiovascular event,MACE),包括全因死亡、非致死性心肌梗死和靶病变重建(target lesion revascularization,TLR)。结果术前符合HAMD抑郁诊断标准的患者为102例(25.5%),术后2周符合诊断标准的患者为154例(38.5%),PCI术后患者的抑郁患病率较术前明显增高(P<0.001)。术后抑郁患者出院后12个月内有31例(20.1%)发生了MACE,明显高于无抑郁的患者(19例,7.7%),P<0.001。Logistic多因素回归分析显示抑郁状态是PCI术后患者12个月MACE的独立危险因素(OR2.34,95%CI1.26～4.03,P=0.024)。结论PCI术后有较高比例的患者存在不同程度的抑郁状态。术后抑郁状态是PCI术后患者发生MACE的独立危险因素。

引用

页码：28 / 31

页数：4

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