不同危险分层急性冠脉综合征患者抑郁症患病率及其程度的研究

摘要

目的 探讨不同危险分层急性冠脉综合征(ACS)患者的心理状态及其与严重程度的相关性.方法 选择418例已确诊为ACS的患者进行汉密顿抑郁量表(HAMD)评分,对ACS伴抑郁症患者在基础治疗的同时,加用抗抑郁药物,8周后进行HAMD评分.结果 418例不同危险分层ACS患者中,轻度抑郁112例,中、重度抑郁40例.不稳定型心绞痛型抑郁症的发生率21.4%(23/107),非ST段抬高心肌梗死患者抑郁症的发生率27.1%(32/118),ST段抬高心肌梗死患者抑郁症的发生率50.3%(97/193).抗抑郁药物治疗前后各组抑郁症患者HAMD评分比较,差异均有统计学意义(P＜0.05).结论 ACS与抑郁症相关,危险度最高的ST段抬高心肌梗死的抑郁发生率最高.抑郁症可加重ACS患者的病情,故在治疗ACS时,更要重视其相伴的精神疾病的诊治.%Objective To investigate the psychological status of patients with different risk stratification of acute coronary syndrome ( ACS ) and its correlation with severity of ACS. Methods Four hundred and eighteen ACS patients were chosen to perform Hamilton depression rating scale ( HAMD ) score. Patients with ACS accompanied by depression were given anti - depression drugs besides basic treatment. HAMD score performed after 8 weeks. Results Among418 patients, 112 had mild depression , 40 had moderate or severe. Incidence of unstable angina depression was 21. 4% ( 23/107 ), and incidence of depression 27. 1% ( 32/118 ) in patients with non - St - segment elevation myocardial infarction, 50. 3% ( 97/193 ) in patients with St - segment elevation myocardial infarction. There was significant difference in HAMD score between pre - treatment and post -treatment ( P <0. 05 ). Conclusion ACS is correlated with depression. The incidence of depression is the highest in patients with highest - risk ST - segment elevation myocardial infarction. Depression can exacerbate the condition of ACS patients. Therefore , diagnosis and treatment of its accompanied mental illness should be laid greater emphasis on when treating ACS.