| Objective: Coronary heart disease is now recognized as a psychosomatic disease. The role of depressive symptom in its occurrence, development and associated catalytic has been confirmed by a large number of clinical practice and researches. Acute coronary syndrome (ACS) as a type of serious coronary heart disease, the relationship with depressive symptom in domestic and abroad is not clearly. The purpose of this study was to observe clinical data, psychological status and biological indicators of ACS patients,to explore the characteristics of them with depressive symptom, so as to provide information for physician to judge and treat patients of ACS with depressive symptom.Methods: During July 2008 and December 2009,200 patients in hospital diagnosed ACS was admitted. These patients whose HAMD depression score were between 7 and 16, would be take out (all 15 patients), All the patients were divided into two groups, according to HAMD depression scores: score≥17 patients (127 cases) were ACS with depressive symptoms patients (named as the depression group); score <7 patients (58 cases) were ACS without depressive symptoms group patients (non-depressed group). C-reactive protein (CRP), interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor (TNF-α) of all patients were measured. Gender, age, smoking, drinking, education, body mass index (BMI), complicating diseases and inflammatory cytokines were compared between the two groups. Final income patients (185cases) were divided by gender, whether smoking, whether drinking, education level, whether complicating diseases,HAMD depression score was compared between two-groups. Statistical software SPSS 13.0 was used to analyze the data. T test, analysis of covariance,χ2 test were used in this study. P<0.05 was considered as the difference was significantly. Results: There were185 patients with ACS in this study. The depression group (HAMD depression score≥17) had 127 cases, accounting for 68.6% (about 63.5% in total ACS patients). 59 cases were male, 68 cases were female. Age was 35-68(52.39±6.577) years, 55 cases (43.3%) had history of smoking, 18cases (14.2%) had history of drinking, BMI23.188±2.537 kg/m2. There were 101 cases (79.5%) with the history of diabetes. There were 95 cases (74.8%) with the history of dyslipidemia. There were 94 cases (74.0%) with the history of hypertension. There were27 cases (21.3%) with junior or below educational level. There were59 cases (46.5%) with high school or below university educational level. There were41 cases (32.3%) with university or above educational level. CRP was 17.74±16.947mg/l, IL-1 0.576±0.22ng/ml, IL-6 was 251.096±91.722pg/ml, TNF-αwas 2.059±0.451 ng /ml.Non-depressed group (HAMD depression score<7) had 58 cases, accounting for 31.4%. 24 cases were male, 34 cases were female. Age was 34-69(55.172±7.209) years, 24 cases (41.4%) had history of smoking, 6 cases (10.3%) had history of drinking, BMI 23.081±2.695 k g/m2. There were 21 cases (36.2%) with the history of diabetes. There were 13 cases (22.4%) with the history of dyslipidemia. There were 46 cases (79.3%) with the history of hypertension. There were 39 cases (67.2%) with junior or below educational level. There were 15 cases (25.9%) with high school or below university educational level. There were 4 cases (6.9%) with university or above educational level. CRP was 2.593±1.778 mg/l, IL-1 was 0.29±0.069 n g /ml, IL-6 was 130. 08±39.879 pg/ml, TNF-αwas 1.366±0.194 n g/ml.Compared age of two groups, depression group was significantly lower than that of non-depressed group(52.39±6.577 v s 55.172±7.209,p=0.006. Education level of high school and above patients were significantly more in depression group than that of non-depressed group(78.7% v s 32.8%,P=0.000), while the education level of junior and below was significantly lesser than that of non-depressed group (21.3% v s 67.2%,P=0.000). Patients with diabetes and dyslipidemia in depression group were significantly more than that in non-depressed group diabetes 79.5% v s 36.2%,dyslipidemia 74.8% v s 22.4%,p=0.000). CRP, IL-1,IL-6, TNF-αlevel in depression group were significantly higher than that in non-depressed group(CRP 17.74±16.947 mg/l v s 2.593±1.778 mg/l,IL-1 0.576±0.22 n g/ml v s 0.29±0.069 n g/ml, IL-6 251.096±91.722 pg/ml v s 130.08±39.879 pg/ml,TNF-α2.059±0.451 n g/ml v s 1.366±0.194 n g/ml, p =0.000).Final income patients (185cases) were divided into two groups by gender, whether smoking, whether drinking, education level, whether complicating diseases. HAMD depression score was compared between groups. Analysis of two-groups shown that:There were no significant differences between smoking history group and no smoking history group;drinking history group and no drinking history group;history of hypertension group and no history of hypertension group in HAMD depression score (P> 0.05). HAMD depression score in Junior and below educational level group was 13.329±6.074, and in high school and above group was 18.543±6.525, in university group was 21.239±5.363. The higher educational level the higher HAMD depression score (p=0.000). HAMD depression score was higher in patients with diabetes than them no history of diabetes (19.656±6.54 v s 13.267±5.363, p=0.009). HAMD depression score in patients with dyslipidemia was higher than that in patients without dyslipidemia (20.565±6.266 v s 13.38±5.326, p= 0.000).Conclusions: This study shown: about 63.5% ACS patients with depressive symptom, presented that ACS patients were easy to be depressive. Patients of ACS with depressive symptom were more seen in younger, higher educational level, with history of diabetes, with history of dyslipidemia, and the higher level of inflammatory factors population, presented that these patients were prone to have depressive symptom. ACS patients of depressive symptom had higher level of inflammatory factors (CRP,IL-1,IL-6,TNF-α) , presented that ACS patients who were higher level of inflammatory factors may have depressive symptom. |
PDF Full Text Request