冠心病支架置入术后再发胸痛与焦虑抑郁的相关性分析

目的探讨冠心病支架置入术后胸痛患者躯体症状与焦虑、抑郁的相互关系。方法采用随机抽样方法从北京安贞医院心内科门诊患者中选取冠心病支架置入术后再发胸痛患者536例，采用医院焦虑抑郁量表（HADS）和患者健康问卷（PHQ 15）进行调查，统计焦虑、抑郁检出率及不同程度躯体症状患者焦虑、抑郁患病相对危险度。结果536例患者中，焦虑、抑郁及焦虑合并抑郁检出率分别为16.6％（89例）、25.4％（136例）、27.2％（146例）。躯体症状与焦虑、抑郁的相关分析显示，PHQ 15总分、PHQ 15阳性症状数目与HADS总分（r＝0.413，P〈0.01；r＝0.375，P〈0.01）、HADS a因子分（r＝0.484，P〈0.01；r＝0.428，P〈0.01）及HADS d因子分（r＝0.381，P〈0.01；r＝0.299，P〈0.01）呈正相关。躯体症状轻度（PHQ 15，5～9分）、中度（PHQ 15，10～14 分）、重度（PHQ 15，15～30分）患者焦虑患病的相对危险度（RR）及95％置信区间（CI）分别为6.42（1.88～9.79）、14.83（6.01～28.59）、27.23（19.23～41.03）；抑郁患病的RR（95％CI）分别为3.21（0.98～3.89）、18.29（9.37～25.16）、42.53（9.14～87.26）；焦虑、抑郁合并患病的RR（95％CI）分别为3.96（1.29～8.06）、11.12（5.12～26.47）、34.73（16.13～81.28）。结论心内科门诊冠心病支架置入术后再发胸痛为主要躯体症状就诊的患者焦虑、抑郁常见；躯体症状与焦虑、抑郁密切相关，躯体症状程度越重数目越多，患焦虑、抑郁相对危险度越高。

Correlative analysis of anxiety,depression and chest pain after coronary stent implantation

ObjectiveTo investigate the prevalence of anxiety, depression and somatic symptoms status,and to explore the relation between somatic symptoms of anxiety and depression. MethodsWithin a sectional survey, 536 outpatients were tested with the hospital anxiety and depression scale（HADS） and the patient health questionnaire 15（PHQ 15）. Prevalence of anxiety and depression, relative risks（RR） of anxiety and depression in patients with different severity somatic symptoms were investigated. ResultsPrevalence rates of anxiety,depression and anxiety combined with depression were 16.6%（89/536）, 25.4%（136/536） and 27.2%（146/536） respectively in the 536 outpatients.Significant positive correlations were observed among PHQ 15 scores, PHQ 15 positive symptom numbers and HADS sores （r=0.413,P〈0.01;r=0.375,P〈0.01）, HAD a sores （r=0.484,P〈0.01;r=0.428,P〈0.01）,HAD d sores（r=0.381,P〈0.01; r=0.299, P〈0.01）. Relative risks （RR） and 95% confidence intervals （CI） for patients with anxiety of low PHQ 15 scores（5 9）,medium PHQ 15 scores （10 14） and high PHQ 15 scores （15 30） were 6.42（1.88 9.79）,14.83（6.01 28.59）,27.23（19.23 41.03） respectively; RR（95% CI） for patients with depression was 3.21（0.98 3.89）,18.29（9.37 25.16） and 42.53（9.14 87.26） respectively; RR （95% CI） for patients with anxiety combined with depression was 3.96（1.29 8.06p）, 11.12（5.12 26.47）, 34.73（16.13 81.28） respectively. ConclusionsThere is a high prevalence of anxiety and depression in cardiology coronary stent implantation outpatients. A positive correlation is observed among anxiety, depression and somatic symptoms.