《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (01): 51-52.

• 临床研究 • 上一篇    下一篇

老年冠心病患者抑郁程度与心肌缺血的关系

吴京兰1; 苏又苏1; 付剑云1; 王晓艳1; 方红城1; 罗国庆2; 盛国太2   

  1. 1.深圳市南山人民医院心内科 广东深圳市 518052;2.江西省人民医院心内科 江西南昌市 330006
  • 收稿日期:2004-08-21 出版日期:2005-01-25 发布日期:2005-01-25

Relationship between depressive degree and myocardial ischemia in elderly patients with coronary artery disease

WU Jing-lan, SU You-su, FU Jian-yun, et al   

  1. Department of Cardiovascular, Nanshan Peoples Hospital, Shenzhen 518052, Guangdong, China
  • Received:2004-08-21 Published:2005-01-25 Online:2005-01-25

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摘要： 目的观察老年患者心肌缺血与抑郁程度的关系,了解老年冠心病患者发生抑郁的一般规律。方法根据流行病研究中心抑郁度量表(CES-D)评分,将完成冠状动脉造影确诊为冠心病的老年患者121例分为无抑郁组(A组,64例),轻中度抑郁组(B组,34例)和严重抑郁组(C组,23例),观察不同组别之间在日常生活和活动平板运动试验中心肌缺血发生状况。结果无抑郁组以单支冠状动脉病变为主 ,轻中度抑郁组单支、双支和 3支病变比例相近;严重抑郁组以 3支病变为主。日常生活中,轻中度抑郁组ST段下降(4.2±1.3)次,ST段下降持续时间(35.8±9.2)min,ST段下降指数(3.28±0.9)min/h,均高于无抑郁组的(1.8±0.3)次、(16.6±4.2)min、(1.76±0.4)min/h和严重抑郁组的(2.1±0.7)次、(17.8±5.8)min、(1.69±0.5)min/h(P<0.05);运动试验中,轻中度抑郁组心肌缺血阳性率与严重抑郁组相近,明显高于无抑郁组(P<0.05)。日常生活中缺血症状与无抑郁组相似,但活动后明显高于无抑郁组(P<0.05)。结论抑郁程度与冠脉病变程度有关,不同抑郁程度的患者心肌缺血的表现不同。

关键词: 抑郁症, 冠状动脉疾病, 心肌缺血

Abstract: Objective To research the relationship between the myocardiac ischemic activity and degree of depression in elderly patients.MethodsThe Center For Epidemiological Studies-Depressive Scale(CES-D) was administered to evaluate depressive degree for 121 patients who were defined as coronary artery diseased by coronary angiography (CAG); group A (n=64) for no depressive symptoms,group B (n=34) for minor depression, group C (n=23) for major depression were studied to observing the myocardial ischemia using Holter's recording and exercise testing.ResultsCAG showed that single vessel disease was more frequently in group A;single,double and three-vessel disease showed approximative proportion in group B,three-vessel disease was more frequently in group C.The times of ST-depress were (4.2±1.3),lasting time of ST-depress was (35.8±9.2) min,and index of ST-depress was (3.28±0.9) min/h,which were higher than those of group A [(1.8±0.3),(16.6±4.2) min,(1.76±0.4) min/h] and group C [(2.1±0.7),(17.8±5.8) min,(1.69±0.5)min/ h](P<0.05);There was significantly frequent myocardial ischemia in group B than in group A during exercise testing (χ2=3.274,P<0.05). patients in group C tended to have approximative incidence of ischemia compared with group A during daily living,but more incidence of ischemia than group B during exercise testing(χ2=5.473,P<0.05).ConclusionThe depressive degree was associated with severity of coronary artery disease,mild to moderate symptoms of depression are associated with an increased likelihood of myocardial ischemia during daily living and exercise,but patients with severity depression absence symptoms of myocardial ischemia during daily living,and exhibit markedly myocardial ischemia during exercise.

Key words: depression, coronary artery diseased, myocardial ischemia