CAJ | 학술논문

目的探讨冠心病(coronary heart disease,CHD)患者经皮冠状动脉支架置人(PCI)术后抑郁障碍对支架内再狭窄(In-stent Restenosis,ISR)的影响,以及可能的病理生理学机制.方法根据患者汉密尔顿抑郁量表(HAMD-24)、抑郁自评量表(SDS)评分,选择冠心病行PCI术后合并抑郁障碍(HAMD-24评分＞8分并SDS评分＞53分)的95例患者为研究组,246例冠心病行PCI无抑郁障碍患者为对照组,观察两组患者12月内ISR的发生情况,并测定术后血清醛固酮(aldosterone,ALD)、高敏C反应蛋白(hs-CRP)及瘦素(Leptin)水平.结果研究组患者发生ISR者明显高于对照组(P=0.003);研究组不同抑郁程度的患者其ISR差异有显著性(χ2=8.148,P=0.017);研究组患者血清ALD、hs-CRP及Leptin水平术后分别高于对照组[ALD(277.4±35.9)ng/L,(258.9±60.9)ng/L,t=3.459,P=0.001 ;hs-CRP(12.03±3.06)mg/L.(11.10±2.806)mg/L,t=2.573,P=0.008;Leptin(5.27±1.07)ng/L,(4.98±0.99)ng/L,t=2.323,P=0.021];Pearson相关分析显示,研究组患者HAMD-24评分分别与术后血清ALD、hs-CRP及;Lptin相关(r=0.291,P=0.026;r=0.350,P=0.014;r=0.312,P=0.023),SDS评分与血清hs-CRP具有相关性(r=0.302,P=0.020).结论冠心病PCI术后合并抑郁障碍患者血清ALD、hs-CRP及Leptin水平较高,ISR发生率明显高于无抑郁障碍冠心病患者,且随抑郁程度加重ISR发生率增加.
목적 탐토관심병(coronary heart disease,CHD)환자경피관상동맥지가치인(PCI)술후억욱장애대지가내재협착(In-stent Restenosis,ISR)적영향,이급가능적병리생이학궤제.방법 근거환자한밀이돈억욱량표(HAMD-24)、억욱자평량표(SDS)평분,선택관심병행PCI술후합병억욱장애(HAMD-24평분＞8분병SDS평분＞53분)적95례환자위연구조,246례관심병행PCI무억욱장애환자위대조조,관찰량조환자12월내ISR적발생정황,병측정술후혈청철고동(aldosterone,ALD)、고민C반응단백(hs-CRP)급수소(Leptin)수평.결과 연구조환자발생ISR자명현고우대조조(P=0.003);연구조불동억욱정도적환자기ISR차이유현저성(χ2=8.148,P=0.017);연구조환자혈청ALD、hs-CRP급Leptin수평술후분별고우대조조[ALD(277.4±35.9)ng/L,(258.9±60.9)ng/L,t=3.459,P=0.001 ;hs-CRP(12.03±3.06)mg/L.(11.10±2.806)mg/L,t=2.573,P=0.008;Leptin(5.27±1.07)ng/L,(4.98±0.99)ng/L,t=2.323,P=0.021];Pearson상관분석현시,연구조환자HAMD-24평분분별여술후혈청ALD、hs-CRP급;Lptin상관(r=0.291,P=0.026;r=0.350,P=0.014;r=0.312,P=0.023),SDS평분여혈청hs-CRP구유상관성(r=0.302,P=0.020).결론 관심병PCI술후합병억욱장애환자혈청ALD、hs-CRP급Leptin수평교고,ISR발생솔명현고우무억욱장애관심병환자,차수억욱정도가중ISR발생솔증가.
Objective To study the impact of depression disorder in patients after coronary stent implantation on incidence rate of in-stent restenosis (ISR) in the coronary heart disease( CHD ), and its possible pathophysiological mechanisms. Methods According to the Hamilton Depression Scale (HAMD-24) and Self-rating Depression Scale(SDS) score,95 patients with unstable angina received coronary drug-eluting stent implantation combined with depression disorder were serve as the study group; randomly selecte 246 cases without depression due to unstable angina pectoris after coronary stent implantation as the control group in the same period. The incidence rate of ISR in these two group were observed, and serum aldosterone ( ALD), high-sensitivity C-reactive protein (hs-CRP) ,Leptin levels in two groups were compared. Results The incidence rate of ISR in study group were significantly higher than that of the control group (28/95 vs 46/246, P＜0. 05). Following with the aggravation of depression disorder,the incidence rate of ISR were elevated( χ2 =8. 148, P=0.017). Serum ALD,hs-CRP and Leptin levels of study group were significantly higher than the control group 7 days later after drug-eluting stent implantation ( ALD:277.4 ± 35.9 vs 258.9 ± 60.9, t= 3. 459, P= 0. 001; hs-CRP: 12.03 ± 3.06 vs 11.10 ±2. 806, t = 2.573, P = 0.008; Leptin:5.27 t 1.07 vs 4.98 ± 0.99, t= 2.323, P= 0.021 ). Pearson correlation analysis showed that its HAMA-24 score was positively correlated with serum ALD ,hs-CRP and Leptin( r=0.291,P=0.026; r=0.350, P=0.014; r=0. 312, P=0.023) ,and SDS score was positively correlated with hs-CRP( r=0. 302, P= 0. 020). Conclusion Serum ALD, hs-CRP and Leptin levels are higher in patients after coronary stent implantation combined with depression in patients, and the incidence rate of ISR is also higher in these patients, and the rates are elevated according to the aggravation of depression disorder.