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

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2024, 51(2)
作者
作者单位

首都医科大学附属北京潞河医院 ;

摘要
【摘要】 研究体外循环(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月到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3d根据抑郁自评量表(SDS)评分分为未发生组(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是影响抑郁的危险因素,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可靠参考依据。
Abstract
【Abstract】 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 group γ- Aminobutyric acid( γ- Compare the concentration of Aminobutyric Acid (GABA) and predict the value of Glu 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 Glu 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.
关键词
【关键词】体外循环;心脏瓣膜置换术;术后抑郁;谷氨酸;γ-氨基丁酸
KeyWord
【Key words】 Extracorporeal circulation; Heart valve replacement surgery; Postoperative depression; Glutamic acid; γ- aminobutyric acid
基金项目
页码 521-524
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梁艳红*. 体外循环心脏瓣膜置换术患者术后抑郁的危险因素分析 [J]. 国际精神病学杂志. 2024; 51; (2). 521 - 524.

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李**复旦大学****** 已认证✔

2025-12-10 03:33:26

本研究围绕体外循环心脏瓣膜置换术患者术后抑郁的危险因素开展分析,选题具有一定的临床价值。研究明确采用 SDS 评分进行抑郁分组,并通过检测血浆 Glu 与 GABA 水平,结合 ROC 曲线及多因素 Logistic 回归评价其预测价值。整体研究设计较为完整,结果提示两种神经递质水平升高与术后抑郁发生相关,为探索 CPB 术后精神心理并发症的潜在生物标志物提供了初步证据。 然而,摘要中仍存在以下需要改进之处:其一,对“未发生组与发生组”的 SDS 分界值描述存在表述反向的问题(SDS≥53 通常为轻度抑郁,应属于发生组),需进一步核实并修正;其二,基线资料虽提示两组无差异,但摘要未说明具体纳入变量,影响可读性;其三,ROC 结果中 Glu 的 AUC 值明显高于 GABA,但未明确两者联合预测的表现,建议在研究中予以补充,以增强临床解释性。 总体而言,该研究提示 Glu 与 GABA 水平可能参与 CPB 术后抑郁的病理过程,具备一定临床参考价值,但变量定义、分组逻辑及结果阐释尚需进一步严谨化,以提升研究结论的可信度与科学性。

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