冠心病PCI治疗后并发抑郁症与血清BDNF及Ghrelin水平的相关性研究

发布时间：2018-04-19 09:55

本文选题：冠心病 + 经皮冠状动脉介入治疗　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的:通过检测冠心病(CHD)经皮冠状动脉介入(PCI)治疗后并发抑郁症患者血清脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)及胃饥饿素(Ghrelin)的水平,探讨冠心病PCI治疗后并发抑郁症与血清BDNF及Ghrelin水平的相关性。方法:选自2016年02月至2016年08月就诊于甘肃省人民医院心内科住院行PCI治疗的冠心病患者90例,于PCI治疗前3日及治疗后3日内分别行汉密尔顿抑郁量表(HAMD)评分,根据HAMD评分进行分组,分为冠心病PCI治疗后伴抑郁组(n=40)和PCI治疗后非抑郁组(n=50)。采用酶联免疫吸附法(ELISA)检测患者血清BDNF及Ghrelin水平,分析二者与冠心病PCI治疗后并发抑郁症之间的相关性。结果:1.一般临床资料比较冠心病PCI治疗后非抑郁组与PCI治疗后伴抑郁组组间性别、吸烟、年龄、身体质量指数、Gensini积分、血压、空腹血糖、血脂、肝功、肾功能等基线资料相匹配,均无统计学意义(P0.05)。2.HAMD评分值比较冠心病PCI治疗后伴抑郁组HAMD评分于PCI治疗后显著高于PCI治疗后非抑郁组(P0.05)。3.血清BDNF、Ghrelin水平比较冠心病PCI治疗后伴抑郁组血清BDNF、Ghrelin水平显著低于PCI治疗后非抑郁组。4.不同抑郁程度间血清BDNF及Ghrelin水平比较PCI治疗后患者抑郁程度越重,其血清BDNF、Ghrelin水平越低(P0.05)。5.血清BDNF、Ghrelin水平与HAMD评分值的相关性及血清Ghrelin水平与BDNF水平的相关性Pearson相关分析显示,血清BDNF、Ghrelin水平与HAMD评分值呈显著负相关(r=-0.711,P0.05;r=-0.711,P0.05),血清Ghrelin水平与BDNF水平呈显著正相关(r=0.787,P0.05)。结论:1.冠心病患者PCI治疗后出现抑郁,说明PCI可能是治疗后伴发抑郁症的诱因之一。2.血清BDNF及Ghrelin水平对PCI治疗后伴发抑郁症可能具有一定的临床预测价值,并且可在一定程度上反映冠心病PCI治疗后抑郁症的严重程度。3.临床医生采用PCI积极诊治冠心病的同时,需对患者及时进行有效的心理状态评估,尽早进行干预治疗,以提高患者生活质量。
[Abstract]:Objective: to detect coronary heart disease (CHD) after percutaneous coronary intervention (PCI) after treatment with depression patients serum brain-derived neurotrophic factor (Brain-derived neurotrophic, factor, BDNF) and ghrelin (Ghrelin) level, to investigate the correlation between depression and serum BDNF and Ghrelin levels of coronary heart disease after PCI treatment. Methods: from from 2016 02 to 2016 08 months of treatment in 90 hospitalized patients with coronary heart disease treated with PCI cases of Department of Cardiology, people's Hospital of Gansu Province, to PCI for 3 days before and after the treatment were performed within 3 days of the Hamilton Depression Scale (HAMD) score, according to the HAMD score were divided into depression group with coronary heart disease after PCI treatment (n=40 the non depression group) and PCI (n=50). After treatment by enzyme linked immunosorbent assay (ELISA) detection of serum BDNF and Ghrelin levels, the analysis of the two patients with coronary heart disease after PCI treatment with anti correlation between depression. Results: 1. The depression group sex, depression group and PCI after the treatment of non general clinical data of coronary heart disease after PCI treatment, smoking, age, body mass index, Gensini score, blood pressure, fasting blood glucose, blood lipid, liver function, renal function and baseline data matching, had no statistical significance (P0.05).2.HAMD score value comparison non depression group coronary heart disease after PCI treatment with depression group HAMD score at PCI after treatment was significantly higher than that of PCI (P0.05).3. after treatment, serum BDNF, serum BDNF Ghrelin levels compared with depression group of coronary heart disease after PCI treatment, the level of Ghrelin was significantly lower than that of PCI after the treatment of non depression group.4. different degree of depression between the serum BDNF and Ghrelin levels after PCI treatment of depression with more weight, the lower the level of serum BDNF, Ghrelin (P0.05).5. BDNF in serum, the correlation Pearson correlation analysis of Ghrelin level and HAMD score and the correlation between serum Ghrelin level and BDNF level display , serum BDNF, Ghrelin levels and HAMD scores were negatively correlated (r=-0.711, P0.05; r=-0.711, P0.05), the serum level of Ghrelin was positively correlated with BDNF level (r=0.787, P0.05). Conclusion: depression occurred in 1. patients with coronary heart disease after PCI treatment, indicating that PCI may be the treatment of comorbid depression factor.2. serum BDNF and Ghrelin levels on PCI after treatment with depression may have clinical value in predicting, and to a certain extent, reflect the severity of coronary heart disease PCI.3. clinicians after treatment of depression with PCI positive diagnosis and treatment of coronary heart disease at the same time, the need for timely effective evaluation of the psychological status of patients with early intervention, in order to to improve the quality of life of patients.

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4;R749.4

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