基于患者报告结局的慢性心力衰竭病人抑郁影响因素分析

目的探讨慢性心力衰竭(CHF)病人抑郁的影响因素,为改善CHF病人抑郁状况提供依据。方法收集526例CHF病人病历报告表信息和患者报告结局量表信息。采用多因素Logistic回归分析临床特征变量中抑郁的影响因素,结构方程模型分析患者报告结局抑郁的影响因素。结果Logistic回归分析显示,女性、职业、头晕、心脏杂音、使用硝酸酯类药物是抑郁的独立影响因素(P<0.05)。结构方程模型分析结果显示,食欲睡眠对抑郁有直接正向影响和间接正向影响,食欲睡眠越差,抑郁的发生风险越高;社会支持对CHF病人抑郁有直接和间接的负性影响;治疗满意度作为内生潜变量对抑郁有直接的负向影响。结论女性为CHF病人抑郁的危险因素,头晕为CHF病人抑郁的高危症状,出现心脏杂音是CHF病人抑郁的高危体征,体力劳动者、服用硝酸酯类药物为CHF病人抑郁的保护因素。食欲睡眠对抑郁有正向影响,社会支持及治疗满意度对抑郁有负向影响。

Analysis of the Influencing Factors of Depression in Patients with Chronic Heart Failure Based on Patient Report Outcomes

Objective To Discuss the influencing factors of depression in patients with chronic heart failure(CHF),and to provide the basis for improving the depression status of CHF patients.Methods Five hundred and twenty-six CHF patients were investigated using the CHF case reported form(CRF)and patient reporting outcome(PRO)measure.Multivariate Logistic regression was used to analyze the influencing factors of depression in clinical characteristic variables,and structural equation model was used to analyze the influencing factors of depression in the PRO.Results Logistic regression analysis results showed that gender,occupation,dizziness,heart murmur,and nitrates were independent factors of depression(P<0.05).The results of structural equation model analysis showed that appetite sleep had direct and indirect positive effects on depression,suggesting that the worse appetite sleep,the more likely the occurrence of depression in patients with CHF.Social support has direct and indirect negative effects on depression in patients with heart failure.As an endogenous latent variable,treatment satisfaction has a direct negative impact on depression.Conclusion Female is risk factors for depression in patients with CHF.Dizziness and heart murmur are high-risk signs for depression in CHF patients.physical workers and taking nitrates are protective factors for depression in patients with CHF.Appetite and sleep has positive effect on depression.Social support and satisfaction have negative effect on depression.