焦虑抑郁障碍对冠心病患者介入治疗前后血清高敏C反应蛋白的影响

发布时间：2018-06-26 01:15

本文选题：冠心病 + 焦虑　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:探讨焦虑抑郁障碍对冠心病患者介入治疗前后血清高敏C反应蛋白的影响及其临床意义。方法:选择2016年3月至2016年9月在吉林大学第一医院心内科因冠心病住院并拟行冠脉造影的患者71例,由本研究者及助手按照汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对研究对象的心理状态进行评价,根据评分结果将行PCI术的患者分为焦虑抑郁PCI组及非焦虑抑郁PCI组,并将行冠脉造影术后未行PCI术的非焦虑抑郁患者作为对照组。抽取所有研究对象术前空腹外周静脉血测定血清高敏C反应蛋白,并于术后第一天再次抽取外周静脉血测定血清高敏C反应蛋白,对术前术后测得的血清高敏C反应蛋白值进行比较。结果:(1)术前:三组间术前Hs-CRP水平差异有统计学意义(P0.05)。经两两组间比较,焦虑抑郁PCI组患者的术前血清Hs-CRP基础水平均明显高于对照组和非焦虑抑郁PCI组(P0.05),而非焦虑抑郁PCI组患者的术前血清Hs-CRP水平与对照组比较无统计学意义。(2)术后:三组间术后Hs-CRP水平差异均有统计学意义(P0.05)。经两两组间比较,焦虑抑郁PCI组患者的术后血清Hs-CRP水平均明显高于对照组和非焦虑抑郁PCI组(P0.05),且非焦虑抑郁PCI组患者的术后血清Hs-CRP水平明显高于对照组(P0.05)。(3)同组前后对比:焦虑抑郁PCI组、非焦虑抑郁PCI组术后Hs-CRP水平分别(7.760±1.850mg/L;4.909±1.076mg/L),较两组术前的血清Hs-CRP水平(3.786±1.473mg/L;2.054±0.950mg/L)明显升高(P0.01)。对照组术前术后血清Hs-CRP水平则无明显统计学差异(P0.05)。结论:(1)术前:焦虑抑郁PCI组患者的Hs-CRP水平均明显高于对照组及非焦虑抑郁PCI组,提示Hs-CRP水平与焦虑抑郁具有较密切的联系,合并焦虑抑郁情绪障碍的冠心病患者体内的炎症反应可能更趋于明显。(2)术后:冠心病患者PCI组术后血清Hs-CRP水平较对照组明显升高,提示冠心病患者行PCI术后可能在短期内触发并加重体内炎症反应。(3)同组术前术后对比:合并焦虑抑郁情绪的患者PCI术后血清Hs-CRP水平较非焦虑抑郁患者PCI术后升高更为明显,提示焦虑抑郁情绪可能会加重冠心病患者PCI术后体内的炎症反应。
[Abstract]:Objective: to investigate the effect of anxiety and depression on serum Gao Min C reactive protein (Gao Min C reactive protein) in patients with coronary heart disease (CHD) before and after interventional therapy. Methods: from March 2016 to September 2016, 71 patients with coronary artery disease were selected from Department of Cardiology, first Hospital of Jilin University. According to the Hamilton anxiety scale (Hama) and Hamilton Depression scale (Hamd), the subjects were evaluated by our researcher and assistant. According to the score, the patients undergoing PCI were divided into anxiety depression PCI group and non-anxiety depression PCI group. Non-anxiety depression patients without PCI after coronary angiography were used as control group. Serum Gao Min C reactive protein (Gao Min C reactive protein) was measured in fasting peripheral venous blood of all subjects before operation, and serum Gao Min C reactive protein (Gao Min C reactive protein) was measured again on the first day after operation. The serum levels of Gao Min C reactive protein (Gao Min C reactive protein) before and after operation were compared. Results: (1) preoperative: there was significant difference in preoperative Hs-CRP level among the three groups (P0.05). By comparison between two groups, The preoperative levels of Hs-CRP in the patients with anxiety and depression PCI were significantly higher than those in the control group and the non-anxiety depression PCI group (P0.05), but the preoperative levels of Hs-CRP in the non-anxiety depression PCI group were not significantly different from those in the control group. (2) postoperative: 3. The levels of Hs-CRP were significantly different between groups (P0.05). By comparison between two groups, The postoperative serum Hs-CRP levels in patients with anxiety and depression were significantly higher than those in control group and non-anxiety depression PCI group (P0.05), and the postoperative Hs-CRP levels in non-anxiety depression PCI group were significantly higher than those in control group (P0.05). The postoperative Hs-CRP levels in the non-anxiety depression PCI group (7.760 卤1.850 mg / L, 4.909 卤1.076 mg / L) were significantly higher than those in the two groups (3.786 卤1.473 mg / L, 2.054 卤0.950 mg / L) (P0.01). There was no significant difference in serum Hs-CRP levels before and after operation in the control group (P0.05). Conclusion: (1) preoperative levels of Hs-CRP in patients with anxiety and depression in PCI group were significantly higher than those in control group and non-anxiety depression PCI group, suggesting that the level of Hs-CRP was closely related to anxiety and depression. The inflammatory reaction in coronary heart disease patients with anxiety and depression disorder may be more obvious. (2) postoperative: the serum Hs-CRP level in PCI group was significantly higher than that in control group. The results suggest that coronary artery disease may trigger and aggravate the inflammatory reaction in patients with coronary heart disease in a short period of time. (3) the serum levels of Hs-CRP in patients with anxiety and depression after PCI were significantly higher than those in patients with non-anxiety and depression after PCI. (3) the levels of Hs-CRP in patients with anxiety and depression were significantly higher than those in patients with anxiety and depression. The results suggest that anxiety and depression may aggravate the inflammatory response after PCI in patients with coronary heart disease.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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