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术前高敏 C 反应蛋白预测行冠状动脉旁路移植术患者的抑郁:一项单中心前瞻性观察研究。

Preoperative high-sensitivity C-reactive protein predicts depression in patients undergoing coronary artery bypass surgery: a single-center prospective observational study.

机构信息

Department of Cardiovascular Surgery, State Key Laboratory of Translational Cardiovascular Medicine, Fuwai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

出版信息

J Thorac Cardiovasc Surg. 2012 Aug;144(2):500-5. doi: 10.1016/j.jtcvs.2012.01.034. Epub 2012 Feb 7.

Abstract

OBJECTIVE

Our objective was to reveal the contribution of preoperative high-sensitivity C-reactive protein (hsCRP) levels to the risk of depression in patients undergoing coronary artery bypass grafting (CABG).

METHODS

In this study, 232 consecutive patients undergoing elective CABG were evaluated for depression utilizing the 9-item Patient Health Questionnaire scale at least 3 days before surgery and 6 months after CABG. In addition, peripheral blood samples were collected at baseline and the circulation levels of hsCRP were measured.

RESULTS

The preoperative and postoperative rate of depression was 18.1%. Interestingly, preoperative depression was independently associated with women (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.13-5.50) and log-transformed hsCRP (OR, 1.16; 95% CI, 1.06-1.27) after adjusting for various factors using logistic regression, including age, sex, and university-level education. Postoperative depression was only associated with log-transformed hsCRP (OR, 1.15; 95% CI, 1.05-1.25) in these patients. Log-transformed hsCRP remained associated with future depression after adjusting for postoperative medications or major adverse cardiovascular events during the follow-up period.

CONCLUSIONS

The present study is the first to report elevated serum hsCRP is an independent predictor for depression in CABG patients not only preoperatively but also up to 6 months after surgery. These clinical findings may reveal a potential target for improving prognosis in CABG patients with depression.

摘要

目的

本研究旨在揭示术前高敏 C 反应蛋白(hsCRP)水平对接受冠状动脉旁路移植术(CABG)患者发生抑郁的风险的影响。

方法

本研究入选了 232 例行择期 CABG 的患者,分别在术前至少 3 天和 CABG 术后 6 个月时使用 9 项患者健康问卷(PHQ-9)量表评估抑郁情况。同时,在基线和术前采集外周血样,检测 hsCRP 循环水平。

结果

术前和术后的抑郁发生率分别为 18.1%。有趣的是,在校正了年龄、性别和大学教育等多种因素后,使用逻辑回归分析发现,术前抑郁与女性(比值比[OR],2.49;95%置信区间[CI],1.13-5.50)和 hsCRP 的对数值(OR,1.16;95% CI,1.06-1.27)独立相关。在这些患者中,术后抑郁仅与 hsCRP 的对数值(OR,1.15;95% CI,1.05-1.25)相关。在校正术后药物或随访期间发生的主要不良心血管事件后,hsCRP 的对数值仍与未来抑郁相关。

结论

本研究首次报告 hsCRP 升高不仅是 CABG 患者术前,而且是术后 6 个月时发生抑郁的独立预测因素。这些临床发现可能为改善 CABG 伴抑郁患者的预后提供潜在目标。

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