抑郁与心血管疾病患者室性心律失常风险的Meta分析

摘要

目的 通过Meta分析,评价抑郁是否增加心血管疾病患者室性心律失常的风险.方法 检索1990年1月～2013年1月发表于Medline、Elsevier、PsyclNFO、中国学术期刊网(CNKI)全文和万方科技期刊全文数据库中关于抑郁和心血管疾病患者室性心律失常风险关系的文献,对文献质量进行严格评价,应用Stata11.0软件对符合标准的资料进行Meta分析,并用Meta回归和亚组分析寻找异质性来源.结果 最终符合标准的7项研究被纳入分析(n =3115),结果显示抑郁使心血管疾病患者室性心律失常风险增加48％(HR 1.48,95％ CI 1.05～2.10,P＜0.05),在冠心病患者中风险更高(HR 1.77,95％CI 1.19 ～2.62,P＜0.01);Meta回归发现研究类型、发表年限是异质性的主要来源.结论 抑郁使心血管疾病患者室性心律失常风险增加,这可能是抑郁增加心血管疾病患者心脏性猝死和全因死亡风险的直接原因.%Objective To explore the relationship between depression and the risk of ventricular arrhythmias in patients with cardiovascular disease.Methods The articles on the relation of depression and ventricular arrhythmias in patients with cardiovascular disease were retrieved by searching Medline,Elsevier,PsyclNFO,CNKI and WANFANG databases from January 1990 to January 2013,the quality of literatures was strictly evaluated,the material conformed to standard were assessed by Meta-analysis with stata 11.0 software,Metaregression and subgroup analyses were performed to identify the source of heterogeneity.Results 7 studies contains 3115 cases of participants were retrieved into this analysis,Meta-analysis results showed that the risk of ventricular arrhythmia in patients with cardiovascular disease concomitant depression was 1.48 times of non-depressive patients(95 ％ CI 1.05 ～2.10,P ＜ 0.05),subgroup analysis indicated a significant correlation between depression and ventricular arrhythmias in CHD patients (HR 1.77,95 ％ CI 1.19 ～ 2.62,P ＜ 0.01),Metaregression showed that the heterogeneity was correlated with study design and publication year.Conclusions Depression increased the risk of ventricular arrhythmias in patients with cardiovascular disease;it may be an important reason that depression increase sudden death and all-cause mortality of these patients.