The Relationship Among Depression, Blood Sugar, Lipids And Cardiac Function In Patients With Chronic Heart Failure

Objective:1.To investigate depression incidence in patients with chronic heart failure(CHF).2.To explore the relationship among depression,fasting blood sugar, lipids and cardiac function in patients with CHE 3.To put forward interventions for controlling depression,which help adjust the levels of blood sugar,lipids and improve cardiac function;and provide scientific evidence for clinical nursing in patients with CHF.Methods:The patients with CHF(cardiac function:NYHAⅡ～Ⅳ)enrolled in this study were hospitalized in Qilu hospital and Shandong traditional Chinese medial hospital from May to December 2008.Their fasting blood sugar and lipids were measured.At the same time,Beck Depression Inventory(BDI) was used to investigate their depression.Based on BDI total scores,the patients were divided into two groups(the score＜10,no depression;the score≥10,depression),and then the levels of fasting blood sugar and lipids were compared between these two groups. Besides,BDI total scores were applied to analyze the relationship between depression and cardiac function.All the data was analyzed by SPSS13.0.Results:1.In 135 patients,the incidence of depression was 80%.Female patients suffering from depression were more than male patients(χ~2=4.688,P=0.030＜0.05),and patients who were age≥65years suffering from depression were more than age＜65 years(χ~2=10.768,P=0.001＜0.01);but the incidence of depression in different education levels had no significant differences(χ~2=0.942,P=0.624＞0.05).2.Compared with patients without depression,the patients with depression had higher levels of fasting blood sugar(FBS) and triglyceride(TG)(Z=-2.525,P=0.012＜0.05; Z=-2.588,P=0.010＜0.05),and had lower levels of high-density lipoprotein cholesterol(HDL-C)(Z=-1.967,P=0.049＜0.05).There were no significant differences in the levels of total cholesterol(TC),low-density lipoprotein(LDL-C) between these two groups(Z=-1.246,P=0.213＞0.05;Z=-1.367,P=0.172＞0.05). Further analysis showed that the levels of FBS had positive correlation with BDI total scores(r=0.323,P=0.000＜0.001),but there was no obvious correlation between the levels of blood lipids and BDI total scores.Regression analysis showed that high BDI total scores could predict the high levels of FBS(R~2=0.105).3.There had statistical significance in BDI total scores among different NYHA cardiac function classes(F=3.521,P=0.032＜0.05).Spearman's rank correlation analysis showed that NYHA cardiac function classes were correlated positively to the BDI total scores(r=0.206,P=0.017＜0.05).Regression analysis indicated that high BDI total scores and low levels of HDL-C were important predictors to the severity of CHF;excluding the effect of HDL-C on cardiac function,the BDI total scores could also predict the severity of CHF independently.Conclusion:1.The incidence of depression in patients with CHF was high.Female patients were susceptible to depression,so were patients over 65 years.2.Depression influenced the levels of fasting blood sugar in patients with CHF.As a result,monitoring the emotion and glucose level for patients dynamically might help the physicians find the non-disease factors contributing to the glucose level poorly controlled,and then prevent the occurrence of diabetes.Depression also influenced the levels of blood lipids in patients with CHF.If depression could be controlled intentionally,the levels of lipids would be adjusted,and then its bad effect to CHF would be prevented.3.High BDI total scores could predict the severity of CHF independently.NYHA classification combined with depression might evaluate the severity of CHF comprehensively.