摘要
目的:研究冠状动脉慢血流患者的焦虑或抑郁状态,并对其潜在机制进行研究。方法:入选我院非典型冠心病患者232例。所有患者进行汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分,且行冠状动脉造影检查,根据造影结果分为慢血流组(n=92)和对照组(n=140)。分析比较两组患者一般情况、焦虑症(HAMA评分≥14分)和抑郁症(HAMD评分≥20分)的患者比例以及血小板、五羟色胺、去甲肾上腺素、多巴胺水平。非典型冠心病是指排除由典型冠状动脉粥样硬化引起管腔狭窄而又具有典型冠心病相关症状的冠心病。结果:慢血流组中焦虑症(42.39%vs 28.57%)及抑郁症(16.31%vs 4.29%)患者比例均高于对照组,差异均有统计学意义(P均<0.05)。慢血流组患者的血小板、五羟色胺、去甲肾上腺素、多巴胺水平均高于对照组,差异均有统计学意义(P均<0.05)。结论:冠状动脉慢血流患者中抑郁症或焦虑症的合并比例明显高于对照人群,提示焦虑或抑郁状态与冠状动脉慢血流之间有一定关联,其机制可能与焦虑症或抑郁症患者血清五羟色胺功能及分泌水平异常及下丘脑-垂体-肾上腺系统的过度激活有关。
Objectives: To observe the prevalence of anxiety or depression in patients with slow coronary artery flow and explore the possible mechanisms.Methods: 232 patients with atypical coronary heart disease were selected. Coronary angiography was performed and all patients were assessed with Hamilton anxiety scale(HAMA) and Hamilton Depression scale(HAMD). According to the results of coronary angiography, patients were divided into two groups: slow blood flow group(n=92) and control group(n=140). HAMA score, HAMD score, and platelet, serotonin, norepinephrine, dopamine levels between the two groups were compared. HAMA score ≥14 refers patients with anxiety disorder, HAMD score ≥20 refers patients with depression.Results: Prevalence of patients with anxiety disorder or depression was significantly higher in the slow blood flow group than in the control group(42.39% vs 28.57%, 16.31% vs 4.29%, respectively, both P<0.05). The levels of platelet, serotonin, norepinephrine and dopamine in the slow blood flow group were also significantly higher than those in the control group(all P<0.05). Conclusions: The incidence of depression or anxiety in patients with slow coronary artery flow is significantly higher than in the control group, our results thus suggesting a close association between anxiety or depression and slow flow of coronary artery. The underlying mechanism might be related to abnormal serotonin function and secretion and hyperactivation of hypothalamus-pituitary-adrenal system in patients with slow coronary artery flow.
作者
冯强
李中中
FENG Qiang;LI Zhong-zhong(Fourth Department of Cardiology,Handan Central Hospital,Handan(056001),China)
出处
《中国循环杂志》
CSCD
北大核心
2018年第12期1189-1192,共4页
Chinese Circulation Journal
