慢性心力衰竭患者心脏再同步治疗（CRT）术后抑郁焦虑障碍的影响因素及对预后的影响分析
Influencing factors of depression and anxiety disorder after cardiac resynchronization therapy (CRT) in patients with chronic heart failure and its impact on prognosis
ES评分 0
| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2019, 46(6) |
| 作者 |
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| 作者单位 |
南阳市中心医院 心血管内科 ;
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| 摘要 |
目的：探究慢性心力衰竭患者进行心脏再同步治疗（CRT）术后发生抑郁、焦虑障碍影响因素及该抑郁、焦虑障碍对患者预后影响。方法：随机纳入本院2017年1月至2019年1月收治160例慢性心力衰竭行CRT置入术治疗患者作为研究对象，患者术后均予以汉密尔顿抑郁焦虑评分量表（HAMA与HAMD）进行评分，依据评分情况分为研究组（纳入抑郁、焦虑障碍患者，86例）、对照组（纳入无抑郁、焦虑障碍患者，74例）。患者持续随访调查6个月，对比术前、术后两组患者6min步行试验、NYHA分级、左心室射血分数（LVEF）、手术相关并发症以及心血管不良事件（MACE）情况。结果：患者文化程度低（HR=1.82，95%CI：1.32~2.73）、经济状况较差（HR=2.03，95%CI：1.42~2.92）是术后抑郁、焦虑障碍的独立影响因素（P<0.05）；随访结束研究组患者6min步行试验相比对照组明显更低（P<0.05）；随访结束两组患者症状NYHA分级、LVEF%与LVEDd指标对比未见统计差异（P>0.05）；术后研究组患者的心绞痛、室性心律失常、心肌梗死等事件发生率相比对照组明显更高，差异存在统计意义（P<0.05）；两组患者手术并发症率对比未见显著差异（P>0.05）。结论：CRT术后患者易合并发生抑郁、焦虑障碍，该症状发生的危险因素包括患者文化程度低、经济状况较差；术后发生抑郁、焦虑障碍患者CRT反应性及患者预后受影响，此类患者更易发生心血管事件。
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| Abstract |
Objective: To explore the influencing factors of depression and anxiety disorder in patients with chronic heart failure after cardiac resynchronization therapy (CRT) and the prognosis of patients with depression and anxiety disorder. Methods: 160 patients with chronic heart failure treated by CRT implantation from January 2017 to January 2019 were randomly enrolled in our hospital. All patients were scored by Hamilton Depression and Anxiety Scale (HAMA and HAMD). According to the score, they were divided into study group (86 patients with depression and anxiety disorder included). Control group (including 74 patients without depression and anxiety disorder). The patients were followed up for 6 months. The walking test, NYHA grading, left ventricular ejection fraction (LVEF), surgical complications and cardiovascular adverse events (MACE) were compared between the two groups before and after operation. Results: Low education level (HR = 1.82, 95% CI: 1.32-2.73), poor economic status (HR = 2.03, 95% CI: 1.42-2.92) were the independent influencing factors of depression and anxiety disorder after operation (P < 0.05). The 6-minute walking test in the study group was significantly lower than that in the control group (P < 0.05). There was no statistical difference in YHA grade, LVEF% and LVEDd (P > 0.05); the incidence of angina pectoris, ventricular arrhythmia and myocardial infarction in the study group was significantly higher than that in the control group (P < 0.05); there was no significant difference in the incidence of surgical complications between the two groups (P > 0.05). CONCLUSION: Patients with CRT are prone to develop depression and anxiety disorder. Risk factors for the occurrence of depression and anxiety disorder include low education level and poor economic status. CRT reactivity and prognosis of patients with depression and anxiety disorder are affected after CRT, and these patients are more prone to cardiovascular events.
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| 关键词 |
慢性心力衰竭；心脏再同步治疗；抑郁、焦虑障碍；预后效果；心血管事件
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| KeyWord |
Chronic heart failure; Cardiac resynchronization therapy; Depression and anxiety disorders; Prognostic effect; Cardiovascular events
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| 基金项目 |
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| 页码 |
1089-1091 |
任芳芳*.
慢性心力衰竭患者心脏再同步治疗（CRT）术后抑郁焦虑障碍的影响因素及对预后的影响分析 [J].
国际精神病学杂志.
2019; 46; (6).
1089 - 1091.