介入途径对冠状动脉介入术后焦虑和抑郁状态的影响

目的:研究经桡动脉或经股动脉冠状动脉介入治疗术后,患者焦虑抑郁状态的发生情况。方法:对99例因冠心病准备行经皮冠状动脉介入治疗(PCI)的患者根据采用路径分为两组:经桡动脉冠状动脉介入治疗(TRI,n=50)和经股动脉行冠状动脉介入治疗(TFI,n=49)。同时采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD),对两组患者术前及术后1d分别进行焦虑抑郁状态评分。HAMA8分定义为焦虑状态,HAMD8分定义为抑郁状态。结果:术前两组患者的HAMA和HAMD评分差异均无统计学意义分别为(7.15±1.78)vs.(7.75±1.82),P=0.216]和(6.80±1.75)vs.(6.78±2.15),P=0.763]。术后TRI组的HAMA平均评分:(9.74±3.36)vs.(12.82±5.68),P=0.038]和HAMD的平均评分:(9.94±3.37)vs.(13.02±3.75),P=0.022)]均显著低于TFI组。TRI组患者焦虑和抑郁状态的发生率显著低于TFI组焦虑状态:18.0%vs.38.8%,P=0.022);抑郁状态:16.0%vs.34.7%,P=0.032]。多因素Logistic分析显示TFI和TRI相比是术后抑郁和焦虑状态的独立预测因素。结论:焦虑和抑郁状态均是PCI术后常见的情绪障碍,而TRI在对患者这两种情绪障碍的影响上均明显优于TFI。

Comparison of effect on mental disorders between transradial and transfemoral coronary intervention

Objective ：The study was conducted to compare the effect of transradial approach and trans femoral approach on anxiety and depression for patients undergoing percutaneous coronary intervention （PCI）. Methods： Ninety nine patients undergoing PCI were randomized to transradial approach （TRI, n =50 ） and transfemoral approach （TFI, n = 49）. All the patients were evaluated by the 24-item Hamilton Depression Rating Scale （HAMD） and Hamilton Anxiety Rating Scale （HAMA） before and 1 day after the procedure. HAMD score 〉 7 was defined as depression and HAMA score 〉 7 as anxiety. Results： At baseline, there was no difference in HAMA （7. 15 ± 1.78） vs. （7. 75 ± 1.82 ）, P = 0. 216 ] or HAMD score （6. 80 ± 1.75） vs. （6. 78 ± 2. 15 ）, P = 0. 763 ] between TFI group and TFI group. However, both the HAMA and HAMD score after procedure were significantly higher in TRI group than patients undergoing TFI HAMA： （9.74 ± 3.36） vs. （ 12. 82 ± 5.68） ,P = 0. 038, HAMD ： （9. 94 ± 3.37） vs. （ 13.02± 3.75 ） ,P = 0. 022 ]. TRI group has higher rate of anxiety and depression compared with TFI group （ Anxiety ： 18.0% vs. 38.8%, P = 0. 022, Depression： 16. 0% vs. 34.7%, P =0. 032）. Logistic regression analysis showed that TFI versus TRI was independent predictor of post-procedure depression and anxiety. Conclusion： Both anxiety and depression are common in patients treated with PCI. TRI is superior to TFI in the effect of PCI on these two mental disorders.