基于“血瘀”证素探析冠心病合并焦虑和/或抑郁状态患者冠状动脉病变的相关因素

Exploration on the correlation of coronary artery disease in patients with coronary heart disease complicated with anxiety and/or depression based on "blood stasis" syndrome element

关键词:  冠心病  焦虑状态  抑郁状态  情绪障碍  冠状动脉病变程度  血瘀

Key words:  coronary heart disease  anxiety state  depressive state  mood disorder  degree of coronary artery disease  blood stasis

摘要:

[目的] 探析冠心病合并焦虑和/或抑郁状态患者冠状动脉病变与“血瘀”证素的相关因素。[方法] 纳入了2019年5月1日—2020年12月31日在上海中医药大学附属岳阳中西医结合医院心内科冠心病患者320例，收集该类患者性别、年龄、文化程度、肥胖程度、腹围、合并疾病病史、冠状动脉病变情况、中医症状及相关实验室观察指标信息，判别证素，并行组间比较。[结果] 焦虑状态在冠心病患者中的总体发病率为39.69%，抑郁状态在冠心病患者中的总体发病率为40.63%。在中青年人群中，女性患者冠心病发病率较男性低，60~74岁是冠心病好发阶段，冠心病合并焦虑和/或抑郁状态患者中女性发病率较男性高。冠心病单支病变中单纯冠心病组较冠心病单纯合并抑郁状态组及冠心病合并焦虑及抑郁状态组两组比例高，差异具有统计学意义（P＜0.05）；三支病变中单纯冠心病组冠心病合并焦虑及抑郁状态组较单纯冠心病组比例高，差异具有统计学意义（P＜0.05）。冠状动脉Gensini评分与白介素-1β （IL-1β）、低密度脂蛋白胆固醇（LDL）及Crouse积分存在正相关线性关系，与射血分数（EF）存在负相关的线性关系，Lo－gistic回归提示血瘀证素与Gensini评分呈正相关。[结论] 冠心病冠状动脉病变支数越多，冠状动脉病变程度越高越容易并发焦虑及抑郁状态等情绪障碍问题；冠心病患者冠状动脉病变程度越高，罹患血瘀证的风险越高。

Abstract:

[Objective] To analyze the correlation between coronary artery disease and "blood stasis" syndrome in patients with coronary heart disease combined with anxiety and/or depression.[Methods] The 320 patients with coronary heart disease in the Department of Cardiology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Shanghai University of Traditional Chinese Medicine from May 1,2019 to December 31,2020 were included.Peripheral,combined disease history,coronary artery disease,Traditional Chinese Medicine symptoms and related laboratory observation index information,distinguish syndrome factors,and compare between groups.[Results] The overall incidence of anxiety and depression in patients with coronary heart disease was 39.69% and 40.63%.In the middle-aged and young population,the incidence of coronary heart disease in female patients is lower than that in male patients.The incidence of coronary heart disease in female patients with anxiety and/or depression is higher than that in male patients between 60 and 74 years old.The proportion of single coronary heart disease group was higher than that of single coronary heart disease group with depression and coronary heart disease group with anxiety and depression (P<0.05).The proportion of three branches of coronary heart disease combined with anxiety and depression was higher in coronary heart disease group than in coronary heart disease group,the differences were statistically significant (P<0.05).Coronary Gensini score is positively correlated with IL-1β,low density lipoprotein cholesterol and crouse score,and negatively correlated with ejection fractions.Logistic regression suggests that blood stasis factor and Gensini score are positively correlated.[Conclusion] The greater the number of coronary artery disease in coronary heart disease,the higher the degree of coronary artery disease,the more likely it is to have emotional disorders such as anxiety and depression.The formation of blood stasis syndrome in patients with coronary heart disease may be related to the degree of coronary artery disease correlation.