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术前抑郁、焦虑状况与冠状动脉旁路移植术后心血管事件发生的关系
Relationship between Depression, Anxiety and Cardiac Events after Coronary Artery Bypass Grafting

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王忠杰 1 *   高文斌 1   李西慧 2  
文摘 目的:前瞻、序列、对比研究我科行冠状动脉旁路移植术(coronary artery bypass grafting,CABG)的患者术后1年抑郁、焦虑的状况以及心血管事件的发生率.方法:2005年10月至2006年8月,以我科连续行择期CABG术的69例患者为对象,分别在术前1周内、术后出院前1天、术后1年使用ZUNG氏抑郁自评量表和焦虑自评量表进行抑郁、焦虑状态评分,同时随访术后1年的心血管事件的发生率.结果:术前24例(34.8%)存在抑郁焦虑状态,出院前33例(47.8%)存在抑郁焦虑状态,术后1年随访时10例(14.5%)存在抑郁焦虑状态.术后1年随访时共有6例(8.7%)患者发生心血管病事件,其中5例再次入院.术前存在抑郁焦虑的患者与不存在抑郁焦虑的患者相比:术后住院时间延长[(19±8)d vs.(16±6)d, P=0.003],容易出现伤口并发症(3/24 vs. 0/45, P=0.039),出院前和术后12月随访时不良情绪的发生率较高(分别为75% vs. 33%, P=0.001; 29% vs. 7%, P=0.017);随访时存在抑郁焦虑的患者与不存在抑郁焦虑的患者相比:术前和术后发生心律失常更多见 (3/10 vs. 2/59, P=0.019;6/10 vs. 2/59,P=0.000),术中移植血管桥数量较多[(3.5±0.5) vs.(3.0±0.9),P=0.049],术后住院时间较长[(24±11)天 vs. (16±6)天,P=0.001],术前存在抑郁焦虑状态比例较高(7/10 vs.3/59,P=0.026),发生心血管事件较多 (3/10 vs. 3/59,P=0.036).结论:行冠状动脉旁路移植术术前不良情绪会导致术后恢复减慢,而术前不良情绪、病情重、术后随访发生心血管事件可能与术后1年的抑郁焦虑状态有关系,需要引起重视.
其他语种文摘 Objective: To prospectively investigate the presence of depression, anxiety symptoms and cardiac e-vents after coronary artery bypass grafting (CABG) . Methods: Sixty nine patients who received scheduled CABG were selected consecutively and their depression and anxiety symptoms were assessed with the Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) before operation, before discharge and 1 year after operation. And cardiac events were also investigated one year after operation. Results: Twenty four patients (34. 8% ) had depression and/or anxiety symptoms before CABG, 33 patients (47. 8% ) had depression and/or anxiety symptoms before discharge, and 10 patients ( 14. 5% ) had depression and/or anxiety symptoms one year after operation. Six patients (8.7% ) had cardiac events, and 5 patients were re-admitted. Depression and anxiety symptoms before operation might lead to prolonged length of stay [(19±8)days vs.(16±6)days, P =0. 003] , more wound complications (3/24 vs. 0/45, P=0.039), and higher rates of bad emotions before discharge (75% vs. 33%, P = 0.001) and one year after operation (29% vs. 7% , P =0. 017) . Those patients with depression and/or anxiety symptoms one year after operation (N=10) had more preoperative arhythmia (3/10 vs. 2/59, P =0.019) and more postoperative arhythmia (6/10 vs. 2/59; P =0.000), more blood vessel grafted [ (3.5±0.5) vs. (3.0±0.9), P=0.049], longer stay in hospital [ (24±1) days vs. (16±6) days, P - 0.001] ], higher rate of anxiety before operation (7/10 vs. 3/59, P=0.026) and more cardiac events in follow-up (3/10 vs. 3/59, P= 0.036) .Conclusion; Preoperative bad emotions may delay postoperative recovery. Preoperative bad emotions, serious pathogenetic condition , and cardiac events followed can lead to depression and/or anxiety symptoms one year after operation. Much attention should be paid to this phenomenon.
来源 中国心理卫生杂志 ,2009,23(2):90-94 【核心库】
关键词 冠状动脉旁路移植术 ; 抑郁 ; 焦虑 ; 心血管事件 ; 随访 ; 前瞻性研究
地址

1. 中国科学院心理研究所, 北京, 100101  

2. 北京大学第一医院心脏外科, 北京, 100034

语种 中文
文献类型 研究性论文
ISSN 1000-6729
学科 基础医学;神经病学与精神病学
文献收藏号 CSCD:3542773

参考文献 共 14 共1页

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引证文献 1 篇

1 李维群 术前访视对心脏介入患者焦虑及并发症的影响 重庆医学,2012,41(19):2002-2003
CSCD被引 2 次

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