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经皮冠状动脉介入治疗术后患者焦虑与抑郁的发生特点及影响因素

[Involvement characteristics and influencing factors of anxiety and depression in patients after percutaneous coronary intervention].

作者信息

Li Yong-bin, Yao Zhu-hua, Xu Zhen-kun, Ma Mei, Cao Yue-juan

机构信息

Department of Cardiology, Tianjin Union Medicine Center, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Jun 5;92(21):1498-501.

Abstract

OBJECTIVE

To explore the involvement characteristics and influencing factors of anxiety and depression in patients after percutaneous coronary intervention (PCI).

METHODS

A total of 396 patients undergoing PCI were investigated between January 2009 and December 2010. All of them completed the Hospital Anxiety and Depression Scale (HADS) before discharge and at 12 months post-PCI. We evaluated the involvement characteristics and used Logistic regression to analyze the influencing factors of mood changes.

RESULTS

The relevant factors of post-PCI anxiety were gender (P = 0.003), age (P = 0.004) and acute myocardial infarction (P = 0.009) while depression was associated with acute myocardial infarction (P < 0.001). A 12-month follow-up study showed that anxiety remained stable in 76.3% of patients while depression in 79.5%. Multi-factor analysis showed that factors of presence of adverse cardiovascular events (OR: 1.323, 95%CI: 1.026 - 1.705, P = 0.031), Seattle angina score (OR: 0.870, 95%CI: 0.772 - 0.981, P = 0.023) and anxiety scores at pre-discharge (OR: 1.228, 95%CI: 1.053 - 1.432, P = 0.009) were correlated with the deterioration degree of depression. And the factor associated with the deterioration of depression was the scores before discharge (OR: 1.287, 95%CI: 1.072 ∼ 1.545, P = 0.007).

CONCLUSION

The levels of anxiety and depression remain stable in the majority of PCI patients at Month 12 post-PCI. Perioperative communication and effective control of postoperative cardiovascular events may ease a patient's negative emotions and improve their living quality.

摘要

目的

探讨经皮冠状动脉介入治疗(PCI)术后患者焦虑和抑郁的发生特点及影响因素。

方法

2009年1月至2010年12月,共调查了396例行PCI术的患者。所有患者在出院前及PCI术后12个月均完成医院焦虑抑郁量表(HADS)评估。我们分析了焦虑和抑郁的发生特点,并采用Logistic回归分析情绪变化的影响因素。

结果

PCI术后焦虑的相关因素为性别(P = 0.003)、年龄(P = 0.004)和急性心肌梗死(P = 0.009),而抑郁与急性心肌梗死相关(P < 0.001)。一项为期12个月的随访研究显示,76.3%的患者焦虑状态保持稳定,79.5%的患者抑郁状态保持稳定。多因素分析显示,不良心血管事件的发生(OR:1.323,95%CI:1.026 - 1.705,P = 0.031)、西雅图心绞痛评分(OR:0.870,95%CI:0.772 - 0.981,P = 0.023)和出院前焦虑评分(OR:1.228,95%CI:1.053 - 1.432,P = 用0.009)与抑郁恶化程度相关。与抑郁恶化相关的因素是出院前评分(OR:1.287,95%CI:1.072 ∼ 1.545,P = 0.007)。

结论

大部分PCI患者在术后12个月时焦虑和抑郁水平保持稳定。围手术期的沟通及术后心血管事件的有效控制可能会缓解患者的负面情绪,提高其生活质量。

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