摘要
目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者焦虑抑郁与炎症反应、血管内皮功能的关系。方法选择2014年2月~2017年4月于石家庄市第一医院心血管内科收治的冠心病患者99例,其中男性51例,女性48例,年龄50~78岁,平均(62.11±3.49)岁。存在焦虑抑郁纳入研究组(n=41),不存在焦虑抑郁纳入对照组(n=58)。通过医院焦虑抑郁量表(HADS)测定焦虑抑郁水平,包括HADS总表(HADS-t)、焦虑亚量表(HADS-a)和抑郁亚量表(HADS-d)。检测患者血清髓过氧化物酶(MPO)、脂氧素A4(LXA4)、C反应蛋白(CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及可溶性血管细胞粘附分子-1(sVCAM-1)水平。测定肱动脉血流介导的内皮依赖性舒张功能(FMD)以及硝酸甘油介导的内皮非依赖性舒张功能(NMD)。结果研究组患者HADS-t、HADS-a及HADS-d评分均明显高于对照组,差异均具有统计学意义(P均<0.05)。与对照组相比,研究组患者血清MPO、LXA4、CRP、IL-8及TNF-α水平明显升高,差异均具有统计学意义(P均<0.05)。研究组患者s VCAM-1水平明显高于对照组,而FMD和NMD水平显著低于对照组,差异均具有统计学意义(P均<0.05)。合并焦虑抑郁的冠心病患者血清MPO、LXA4、CRP、IL-8、TNF-α及s VCAM-1水平与HADS-t、HADS-a及HADS-d评分均呈正相关(P均<0.05),而FMD、NMD与HADS-t、HADS-a及HADS-d评分均呈负相关(P均<0.05)。结论合并焦虑抑郁的冠心病患者炎症反应及血管内皮功能损伤更严重,且炎症因子水平与焦虑抑郁水平呈正相关,血管内皮功能与焦虑抑郁水平呈负相关。
Objective To discuss the relationship among anxiety-depression, inflammatory response and vascular endothelial function in patients with coronary heart disease （CHD）. Methods CHD patients （n=99, male 51, female 48, aged from 50 to 78 and average age=62.11±3.49） were chosen from the Department of Cardiovascular Medicine, First Hospital of Shijiazhuang City from Feb. 2014 to Apr. 2017. The patients with anxiety-depression were included into study group （n=41） and those without anxiety-depression, into control group （n=58）. The level of anxiety-depression was determined by using hospital anxiety and depression scale （HADS）, including total HADS （HADS-t）, HADS for anxiety （HADS-a） and HADS for depression （HADS-d）. The levels of serum myeloperoxidas （MPO）, lipoxin A4 （LXA4）, C-reactive protein （CRP）, interleukin-8 （IL-8）, tumor necrosis factor-α （TNF-α） and soluble vascular cell adhesion molecules-1 （sVCAM-1） were detected. The endothelium-dependent brachial artery flow-mediated dilation （FMD） and non-endothelium-dependent nitroglycerin-mediated dilatation （NMD） were determined. Results The scores of HADS-t, HADS-a and HADS-d were all higher in study group than those in control group （all P〈0.05）. Compared with control group, levels of MPO, LXA4, CRP, IL-8 and TNF-α increased significantly in study group （all P〈0.05）. The level of sVCAM-1 was significantly higher, and levels of FMD and NMD were significantly lower in study group than those in control group （all P〈0.05）. The levels of serum MPO, LXA4, CRP, IL-8, TNF-α and sVCAM-1 were positively correlated to scores of HADS-t, HADS-a and HADS-d （all P〈0.05）. The levels of FMD and NMD were negatively correlated to scores of HADS-t, HADS-a and HADS-d （all P〈0.05）. Conclusion Inflammatory response and injury of vascular endothelial function are more serious in CHD patient complicated by anxiety-depression. The levels of inflammatory factorsare positively corr
出处
《中国循证心血管医学杂志》
2018年第2期199-202,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
石家庄市科技计划(141462823)
关键词
不良情绪
冠心病
炎症反应
作用机制.
Adverse emotions
Coronary heart disease
Inflammatory response
Mechanism of action
