中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
4期
702-709
,共8页
心力衰竭%抑郁%焦虑%Meta分析
心力衰竭%抑鬱%焦慮%Meta分析
심력쇠갈%억욱%초필%Meta분석
Heart failure%Depression%Anxiety%Meta-analysis
目的：运用循证医学方法，对我国心力衰竭患者抑郁焦虑发病率及其影响因素、预后、干预作用进行系统分析。方法以“抑郁”、“焦虑”、和“心衰”、“心力衰竭”、“慢性充血性心力衰竭”、“急性心力衰竭”为检索词，计算机检索生物医学文献数据库（CBM）、万方数据库（Wanfang）、维普数据库（VIP）和PubMed，收集36篇关于心力衰竭患者伴发抑郁焦虑的有关研究，应用Stata 12.0软件进行统计分析。结果我国心衰患者抑郁与焦虑的发病率均为40.1%，且心功能级别与抑郁的发生呈正向关系；通过亚组分析，女性的发病率高于男性，心衰伴抑郁焦虑患者的死亡率明显高于非抑郁焦虑组（OR＝0.55，95% CI＝0.39～0.76），而再次入院率在两组之间无统计学差异（OR＝0.74，95% CI＝0.54～1.01）；对抑郁焦虑干预有助于心衰患者预后，其死亡率及再入院率均低于非干预组，差异有统计学意义（OR＝1.97，95% CI＝1.36～2.87；OR＝3.14，95%CI＝1.43～6.92）。结论我国心衰患者抑郁焦虑发病率较高，且与性别、心衰严重程度、调查量表等因素有关；抑郁焦虑不利于心衰患者的预后，通过人为干预，可降低心衰伴抑郁焦虑患者不良事件的发生。
目的：運用循證醫學方法，對我國心力衰竭患者抑鬱焦慮髮病率及其影響因素、預後、榦預作用進行繫統分析。方法以“抑鬱”、“焦慮”、和“心衰”、“心力衰竭”、“慢性充血性心力衰竭”、“急性心力衰竭”為檢索詞，計算機檢索生物醫學文獻數據庫（CBM）、萬方數據庫（Wanfang）、維普數據庫（VIP）和PubMed，收集36篇關于心力衰竭患者伴髮抑鬱焦慮的有關研究，應用Stata 12.0軟件進行統計分析。結果我國心衰患者抑鬱與焦慮的髮病率均為40.1%，且心功能級彆與抑鬱的髮生呈正嚮關繫；通過亞組分析，女性的髮病率高于男性，心衰伴抑鬱焦慮患者的死亡率明顯高于非抑鬱焦慮組（OR＝0.55，95% CI＝0.39～0.76），而再次入院率在兩組之間無統計學差異（OR＝0.74，95% CI＝0.54～1.01）；對抑鬱焦慮榦預有助于心衰患者預後，其死亡率及再入院率均低于非榦預組，差異有統計學意義（OR＝1.97，95% CI＝1.36～2.87；OR＝3.14，95%CI＝1.43～6.92）。結論我國心衰患者抑鬱焦慮髮病率較高，且與性彆、心衰嚴重程度、調查量錶等因素有關；抑鬱焦慮不利于心衰患者的預後，通過人為榦預，可降低心衰伴抑鬱焦慮患者不良事件的髮生。
목적：운용순증의학방법，대아국심력쇠갈환자억욱초필발병솔급기영향인소、예후、간예작용진행계통분석。방법이“억욱”、“초필”、화“심쇠”、“심력쇠갈”、“만성충혈성심력쇠갈”、“급성심력쇠갈”위검색사，계산궤검색생물의학문헌수거고（CBM）、만방수거고（Wanfang）、유보수거고（VIP）화PubMed，수집36편관우심력쇠갈환자반발억욱초필적유관연구，응용Stata 12.0연건진행통계분석。결과아국심쇠환자억욱여초필적발병솔균위40.1%，차심공능급별여억욱적발생정정향관계；통과아조분석，녀성적발병솔고우남성，심쇠반억욱초필환자적사망솔명현고우비억욱초필조（OR＝0.55，95% CI＝0.39～0.76），이재차입원솔재량조지간무통계학차이（OR＝0.74，95% CI＝0.54～1.01）；대억욱초필간예유조우심쇠환자예후，기사망솔급재입원솔균저우비간예조，차이유통계학의의（OR＝1.97，95% CI＝1.36～2.87；OR＝3.14，95%CI＝1.43～6.92）。결론아국심쇠환자억욱초필발병솔교고，차여성별、심쇠엄중정도、조사량표등인소유관；억욱초필불리우심쇠환자적예후，통과인위간예，가강저심쇠반억욱초필환자불량사건적발생。
Objective To assess the prevalence of depression and anxiety, its influencing factors, and intervention efficiencies among Chinese patients with heart failure (HF). Methods Thirty-six papers about HF patients with depression and anxiety were collected through searching in computer databases (CBM, Wanfang, VIP, and PubMed) using key words such as 'depression', 'anxiety', 'heart failure', 'chronic congestive heart failure' and 'acute heart failure'. Stata 12.0 software was used to perform statistical analysis. Results The morbidity of depression or anxiety was 40.1% among HF patients in China and which was positively correlated with New York Heart Association functional classes. The incidence rate of women was higher than that of men. The mortality of HF patients with depression and anxiety was higher than those without depression and anxiety (OR=0.55, 95% CI=0.39-0.76), but the rate of re-hospitalization (OR=0.74, 95%CI=0.54-1.01) had no significant differences between two groups. We also found that the intervention in diseases of depression and anxiety make HF patients had a good prognosis. The mortality and the rate of re-hospitalization in the HF patients with interventions were significantly lower than in those without interventions (OR=1.97, 95%CI=1.36-2.87;OR=3.14, 95%CI=1.43-6.92). Conclusions The morbidity of depression and anxiety were relatively higher among Chinese patients suffering from HF and which was varied by gender, New York Heart Association-defined HF severity and diagnostic methods. Depression and anxiety were harmful to HF patients, and interventions in depression and anxiety could promote the prognosis of HF patients.
