贵州医科大学学报

2020, v.45;No.238(07) 816-821

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焦虑抑郁对急性心肌梗死PCI术后患者hs-CRP、hs-cTnT、住院时间及近期预后的影响
Effect of Anxiety and Depression on hs-CRP,hs-cTnT,Length of Hospital Stay and Short-Term Prognosis in Patients with Acute Myocardial Infarction after PCI

杜书敏;李云鸿;周海燕;王艺明;刘兴德;
DU Shumin;LI Yunhong;ZHOU Haiyan;WANG Yiming;LIU Xingde;Department of Cardiovascular Medicine,the Affiliated Hospital of Guizhou Medical University;Department of Psychology,the Affiliated Hospital of Guizhou Medical University;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine;

摘要(Abstract):

目的:探讨焦虑抑郁对急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)后患者血清超敏c-反应蛋白(hs-CRP)、超敏肌钙蛋白T(hs-cTnT)、住院时间及近期预后的影响。方法:选取行急诊PCI术后的急性ST段抬高型心肌梗死(STEMI)患者160例,于术后第2天采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对患者进行评分,根据评分分为焦虑抑郁组(n=41,有焦虑且有抑郁)、焦虑组(n=33,有焦虑但无抑郁)、抑郁组(n=40,无焦虑但有抑郁)及对照组(n=46,无焦虑且无抑郁);于术后第2天清晨抽取4组患者空腹外周静脉血,采用颗粒增强免疫透射比浊法检测血清hs-CRP水平,采用电化学发光法检测血清hs-cTnT水平;于入院后24 h内收集4组患者一般临床特征资料,并统计住院时间;于手术后1个月内对4组患者进行随访,记录主要心血管不良事件(MACE)的发生情况。结果:焦虑抑郁组、焦虑组及抑郁组患者血清hs-CRP水平高于对照组,差异有统计学意义(P <0. 05);焦虑抑郁组患者MACE发生率高于对照组,差异有统计学意义(P <0. 05)。结论:焦虑抑郁情绪会增加急性心肌梗死PCI术后患者血清hs-CRP水平和术后1个月内MACE的发生,但对患者血清hs-cTnT水平及住院时间无明显影响。
Objective: To investigate the effect of the anxiety and depression on serum hypersensitivity c-reactive protein( hs-CRP),hypersensitivity troponin T( hs-cTnT),the length of hospital stay and short-term prognosis of patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI). Methods: One hundred and sixty patients with acute ST-segment elevation myocardial infarction( STEMI) after emergent PCI were selected. On the second day after PCI,these patients were evaluated to score the self-assessment scale for anxiety( SAS) and self-assessment scale for depression( SDS). Based on their SAS and SDS scores,these patients were divided into 4 groups:anxiety and depression group( n = 41,anxiety and depression),anxiety group( n = 33,only anxiety but no depression),depression group( n = 40,no anxiety but depression) and Control group( n = 46,no anxiety and no depression). Fasting peripheral venous blood was drawn from these patients in the early morning of the second day after PCI. Serum hs-CRP level was detected by particle-enhanced turbidimetric immunoassay( PETIA),and electrochemiluminescence method was used to detect serum hs-cTnT levels. The general clinical characteristics of these patients were collected within 24 hours after the admission,and the hospital stay was counted. These patients were followed up within 1 month after surgery to record the major cardiovascular adverse events( MACE). Results: The levels of serum hs-CRP were higher in the anxiety and depression group,the anxiety group and the depression group than those in the control group( P < 0. 05). The incidence of MACE was higher in the anxiety and depression group than that in the control group( P < 0. 05). Conclusion: Anxiety and depression can increase the serum hs-CRP level and the incidence of MACE in patients with AMI after PCI,but it has no significant effect on the serum hs-cTnT level and hospital stay.

关键词(KeyWords): 焦虑;抑郁;急性心肌梗死;超敏C反应蛋白;超敏肌钙蛋白T;主要心血管事件
anxiety;depression;acute myocardial infarction(AMI);hypersensitive c-reactive protein(hs-CRP);hypersensitive troponin t(hs-cTnT);major adverse cardiovascular events(MACE)

Abstract:

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基金项目(Foundation): 国家自然科学基金(31760294,81560056,81904319,81960315);; 贵州省重性抑郁障碍精准诊疗国际科技合作基地[黔科合人才平台(2018)5802];; 贵州省教育厅青年科技人才成长项目[黔教合KY字(2018)182]

作者(Author): 杜书敏;李云鸿;周海燕;王艺明;刘兴德;
DU Shumin;LI Yunhong;ZHOU Haiyan;WANG Yiming;LIU Xingde;Department of Cardiovascular Medicine,the Affiliated Hospital of Guizhou Medical University;Department of Psychology,the Affiliated Hospital of Guizhou Medical University;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine;

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DOI: 10.19367/j.cnki.2096-8388.2020.07.012

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