796例慢性心力衰竭患者并发抑郁障碍的相关因素分析

目的探讨慢性心力衰竭(CHF)患者并发抑郁障碍的危险因素。方法连续入选CHF患者796例,收集其流行病学资料,采用汉密尔顿抑郁量表24项(HAMD)进行心理评定,HAMD评分<8分为无抑郁,≥8分为抑郁,logistic回归分析抑郁发生的危险因素。结果 153例HAMD评分≥8分,抑郁患病率19.22%。抑郁患病率女性高于男性;年龄≥65岁高于<65岁患者;病程≥24个月高于病程<24个月;丧失工作和生活能力者高于工作和生活能力存在者;吸烟者低于不吸烟者(P<0.05,P<0.01)。女性、年龄≥65岁、病程≥24个月以及丧失工作和生活能力者发生抑郁的风险增加,吸烟患者发生抑郁的风险降低。结论约1/5的CHF患者并发不同程度的抑郁障碍,女性、年龄≥65岁、病程≥24个月以及丧失工作和生活能力的患者有更高的抑郁患病风险。

Related factors for complicating depression in 796 patients with chronic heart failure

Objective To investigate the prevalence and risk factors for complicating depression in patients with chronic heart failure(CHF).Methods 796 patients with CHF were recruited successively and clinical data were collected.Hamilton Depression scale(HAMD) was used to evaluate the level of depression.Stepwise logistic regression analysis was used to determine risk factors for depression.Results The prevalence of depression was 19.22%in 796 patients with CHF.The incidence of depression was significantly higher in female patients than in male patients and in aged patients than in middle-aged patients.The prevalence of depression in patients with loss of ability to work and live was significantly higher than that in patients with work and living ability and higher in patients with longer disease course than in patients with shorter duration of illness. However,the prevalence of depression in smokers was significantly lower than that in non-smokers (P<0.05,P<0.01).Logistic regression analysis showed that the patients with the factors such as female,the elderly,long disease course,and loss of ability to work and live were at high risk for depression,while smoking reduced the risk of depression.Conclusion Around one-fifth of the CHF patients was complicated with various degrees of depression,and the factors such as female, the elderly,long disease course and loss of ability to work and live increased risk of depression.