摘要
目的检测冠心病患者经皮冠状动脉介入治疗(PCI)后血清尿酸水平,同时对PCI后的冠状动脉粥样硬化性心脏病(冠心病)患者进行抑郁及支架内再狭窄评定,并探讨术后抑郁及尿酸水平与术后2年内支架内再狭窄的相关性。方法选取2017年1月至2018年4月于北京航天总医院住院治疗并行PCI的202例冠心病患者为研究对象。采用抑郁自评量表(SDS)、24项版本汉密尔顿抑郁量表(HAMD-24)评定术后1周患者是否发生抑郁;采用酶联免疫吸附(ELISA)法检测术后24 h患者血清尿酸水平;全自动生化分析仪检测各血糖、血脂指标。采用冠状动脉造影评定患者术后2年内是否发生支架内再狭窄并将患者分为非狭窄组和狭窄组。观察PCI后支架内再狭窄患者血清尿酸水平与抑郁评分相关性及影响冠心病患者PCI后支架内再狭窄的危险因素。结果狭窄组SDS评分、HAMD-24评分、血清尿酸水平及抑郁患者比例均高于非狭窄组,差异有统计学意义(P<0.05);Pearson法分析结果显示,冠心病支架置入术后支架内再狭窄患者血清尿酸水平与SDS、HAMD-24评分呈正相关(r=0.620、0.685,P<0.05);Logistic回归分析发现尿酸(OR=1.931,95%CI:1.235~3.018,P=0.006)、SDS评分(OR=1.953,95%CI:1.271~3.002,P=0.004)、HAMD-24评分(OR=2.094,95%CI:1.469~2.984,P=0.003)是影响冠心病患者支架置入术后支架内再狭窄的独立危险因素(P<0.05)。结论冠心病患者PCI后并发抑郁症及尿酸水平与患者发生支架内再狭窄有密切联系,对抑郁的研究可能有利于患者术后治疗方案的选取及支架内再狭窄的预防。
Objective To detect the level of serum uric acid(SUA)and review depression and in-stent restenosis(ISR)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI),and investigate the correlation among depression,SUA level and ISR within 2 y after PCI.Methods CHD patients(n=202)undergone PCI were chosen from Beijing Aerospace General Hospital from Jan.2017 to Apr.2018.The self-rating depressive scale(SDS)and 24-item Hamilton Depression Rating Scale(HAMD-24)were applied to assess whether patients had depression after PCI for 1 week.The level of SUA was detected by using ELISA after PCI for 24 h,and indexes of blood sugar and blood fat were detected by using automatic biochemical analyzer.The incidence of ISR was determined by using coronary angiography(CAG)within 2 y after PCI,and the patients were divided into non-ISR group and ISR group.The correlation between SUA level and depression scores in ISR patients,and ISR risk factors were observed after PCI in CHD patients.Results The scores of SDS and HAMD-24,SUA level and percentage of patients with depression all were higher in ISR group than those in non-ISR group(P<0.05).The results of Pearson analysis showed that SUA level was positively correlated to scores of SDS and HAMD-24(r=0.620,r=0.685,P<0.05)in ISR patients.The results of Logistic regression analysis showed that SUA(OR=1.931,95%CI:1.235~3.018,P=0.006),SDS scores(OR=1.953,95%CI:1.271~3.002,P=0.004)and HAMD-24 scores(OR=2.094,95%CI:1.469~2.984,P=0.003)were independent risk factors of ISR after PCI(P<0.05).Conclusion There is a closely correlation among depression,SUA level and ISR in CHD patients after PCI.The study on depression may be propitious to select therapeutic plan and prevent ISR for patients after PCI.
作者
陆蕙
胡东南
王蓉
Lu Hui;Hu Dongnan;Wang Rong(Second Department of Cardiology,Beijing Aerospace General Hospital,Beijing 100076,China;不详)
出处
《中国循证心血管医学杂志》
2020年第9期1118-1121,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
冠心病
经皮冠状动脉介入治疗
支架内再狭窄
血清尿酸
抑郁
Coronary heart disease
Percutaneous coronary intervention
In-stent restenosis
Serum uric acid
Depression
