老年冠心病患者经皮冠状动脉介入治疗术后焦虑抑郁对不良心血管事件发生率的影响

摘要

Objective To determine the effect of anxiety and depression on the incidence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in the elderly patients with coronary heart diseases.Methods A total of 400 patients with coronary heart diseases who underwent PCI in our hospital from March 2012 to September 2015 were recuited in this study.According to the results of self rating anxiety scale and self rating depression scale in 7 to 14 d after PCI, the patients were divided into anxiety and depression group (with anxiety and/or depression, n=88) and control group (n=279).The incidence of MACE within 1 year after PCI was compared between the 2 groups.Multiple logistic regression analysis was used for the relationship of anxiety and depression with the occurrence of MACE.Results The MACE incidence was 25.00% in the anxiety and depression group, significantly higher than that in the control group (13.98%, Chi square=5.864, P=0.015).Stepwise forward logistic regression analysis indicated that high-density lipoprotein cholesterol reduction (OR=0.692), more branches of coronary artery lesions (OR=2.987), depression and anxiety (OR=2.164) were independent risk factors for MACE in the elderly patients with coronary heart disease after PCI (P<0.05).Conclusion Anxiety and depression increase the risk of MACE in elderly patients with coronary heart disease after PCI.%目的 探讨焦虑抑郁情绪对老年冠心病患者行经皮冠状动脉介入治疗(PCI)术后并发主要不良心血管事件(MACE)的影响.方法 选取2012年3月至2015年9月在南充市身心医院实施PCI手术治疗的冠心病患者400例进行研究,根据PCI术后7~14 d患者是否并发焦虑和抑郁分组:焦虑抑郁组(n=88)和正常对照组(n=279).对比两组患者PCI术后1年MACE的发生率,多因素logistic回归分析焦虑抑郁与患者PCI术后MACE的关系.结果 焦虑抑郁组患者的MACE事件发生率为25.00%,高于正常组13.98%,差异具有统计学意义(x2=5.864,P=0.015);逐步向前logistic回归分析结果表明高密度脂蛋白胆固醇(HDL-C)降低(OR=0.692)、冠脉病变支数增加(OR=2.987)、并发焦虑抑郁(OR=2.164)是老年冠心病患者PCI术后发生MACE事件的独立危险因素(P<0.05).结论 老年冠心病患者PCI术后并发焦虑抑郁可增加MACE事件的发生率.