| 刘永国,王凤霞,李安娜,赵培新,李国庆.急性心肌梗死患者PCI治疗后抑郁对心率变异性、内皮功能及不良心血管事件发生率的影响[J].,2021,(2):333-337 |
| 急性心肌梗死患者PCI治疗后抑郁对心率变异性、内皮功能及不良心血管事件发生率的影响 |
| Influence of Depressive on Heart Rate Variability, Endothelial Function and Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction after PCI |
| 投稿时间：2020-03-29 修订日期：2020-04-23 |
| DOI：10.13241/j.cnki.pmb.2021.02.029 |
| 中文关键词: 急性心肌梗死 经皮冠状动脉介入 抑郁 心率变异性 内皮功能 不良心血管事件 |
| 英文关键词: Acute myocardial infarction Percutaneous coronary intervention Depressive Heart rate variability Endothelial function Major adverse cardiovascular events |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2017D01C115） |
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| 中文摘要: |
| 摘要 目的：探讨急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）治疗后抑郁对心率变异性（HRV）、内皮功能及不良心血管事件（MACE）发生率的影响。方法：选择2017年1月-2018年12月期间在本院接受PCI治疗的AMI患者117例作为研究对象，根据PCI术后出院当日的抑郁自评量表（SDS）评分值将其分为抑郁组（评分值≥53分）41例、非抑郁组（评分值＜53分）76例。对比两组患者HRV相关指标[正常RR间期标准差（SDNN）、5 min内正常RR间期平均值标准差（SDANN）、相邻正常RR间期差值均方的平方根（RMSSD）、总功率（TP）、低频功率（LF）、高频功率（HF）、低频功率与高频功率比值（LF/HF）]、内皮功能指标[内皮依赖性血管舒张功能（FMD）、非内皮依赖性血管舒张功能（NMD）]水平差异，记录两组随访期内MACE发生情况。结果：PCI术后出院当日，抑郁组患者的HRV时域指标SDNN、SDANN、RMSSD水平低于非抑郁组患者；频域指标中LF、LF/HF的水平高于非抑郁组，HF的水平低于非抑郁组（P＜0.05），两组患者TP水平的差异无统计学意义（P＞0.05）。抑郁组患者的FMD、NMD水平均低于非抑郁组患者，差异有统计学意义（P＜0.05）。随访期内，抑郁组患者的MACE总发生率、再发心肌梗死发生率高于非抑郁组，差异有统计学意义（P＜0.05）。两组患者顽固性心绞痛、新发心肌梗死、心力衰竭、心源性死亡发生率的差异无统计学意义（P＞0.05）。结论：AMI患者PCI后合并抑郁可能对心血管系统造成负面影响并最终增加MACE的发生风险。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the influence of depressive on heart rate variability (HRV), endothelial function and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention (PCI). Methods: 117 AMI patients underwent PCI treatment in our hospital during January 2017 to December 2018 were selected as study subjects. According to the self-rating depression scale (SDS) score on discharge day after PCI, all patients were divided into depression group (score≥53, n=41) and non-depression group (score<53, n=76). Two groups related parameters[standard diviation of NN intervals(SDNN), standard deviation of average NN intervals(SDANN), root mean square successive difference (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF], endothelial function indexes[flow mediated dilation(FMD), nitroglycerin-mediated dilatio(NMD)] levels difference were compared, the occurrence of MACE was recorded during the follow-up period between the two groups. Results: On discharge day after PCI, SDNN, SDANN and RMSSD levels in the depression group were lower than those in the non-depression group, LF and LF/HF were higher than those in the non-depression group, HF levelwas lower than that in the non-depression group(P<0.05), there was no significant difference in TP between two groups(P>0.05). The levels of FMD, NMD in depression group were lower than those in the non-depression group, the difference were statistically significant (P<0.05). During the follow-up period, the total incidence of MACE and recurrent myocardial infarction in depression group were higher than those in the non-depression group, the difference were statistically significant (P<0.05). There were no significant difference in the incidence of refractory angina pectoris, new myocardial infarction, heart failure and cardiac death between the two groups(P>0.05). Conclusion: Depressive in AMI patients after PCI may negatively affect the cardiovascular system and eventually increase the incidence risk of MACE. |
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