本文選題：冠心病 + 經(jīng)皮冠狀動脈介入治療��； 參考：《寧夏醫(yī)科大學》2017年碩士論文

【摘要】：目的:通過檢測冠心病(CHD)經(jīng)皮冠狀動脈介入(PCI)治療后并發(fā)抑郁癥患者血清腦源性神經(jīng)營養(yǎng)因子(Brain-derived neurotrophic factor,BDNF)及胃饑餓素(Ghrelin)的水平,探討冠心病PCI治療后并發(fā)抑郁癥與血清BDNF及Ghrelin水平的相關性。方法:選自2016年02月至2016年08月就診于甘肅省人民醫(yī)院心內(nèi)科住院行PCI治療的冠心病患者90例,于PCI治療前3日及治療后3日內(nèi)分別行漢密爾頓抑郁量表(HAMD)評分,根據(jù)HAMD評分進行分組,分為冠心病PCI治療后伴抑郁組(n=40)和PCI治療后非抑郁組(n=50)。采用酶聯(lián)免疫吸附法(ELISA)檢測患者血清BDNF及Ghrelin水平,分析二者與冠心病PCI治療后并發(fā)抑郁癥之間的相關性。結果:1.一般臨床資料比較冠心病PCI治療后非抑郁組與PCI治療后伴抑郁組組間性別、吸煙、年齡、身體質(zhì)量指數(shù)、Gensini積分、血壓、空腹血糖、血脂、肝功、腎功能等基線資料相匹配,均無統(tǒng)計學意義(P0.05)。2.HAMD評分值比較冠心病PCI治療后伴抑郁組HAMD評分于PCI治療后顯著高于PCI治療后非抑郁組(P0.05)。3.血清BDNF、Ghrelin水平比較冠心病PCI治療后伴抑郁組血清BDNF、Ghrelin水平顯著低于PCI治療后非抑郁組。4.不同抑郁程度間血清BDNF及Ghrelin水平比較PCI治療后患者抑郁程度越重,其血清BDNF、Ghrelin水平越低(P0.05)。5.血清BDNF、Ghrelin水平與HAMD評分值的相關性及血清Ghrelin水平與BDNF水平的相關性Pearson相關分析顯示,血清BDNF、Ghrelin水平與HAMD評分值呈顯著負相關(r=-0.711,P0.05;r=-0.711,P0.05),血清Ghrelin水平與BDNF水平呈顯著正相關(r=0.787,P0.05)。結論:1.冠心病患者PCI治療后出現(xiàn)抑郁,說明PCI可能是治療后伴發(fā)抑郁癥的誘因之一。2.血清BDNF及Ghrelin水平對PCI治療后伴發(fā)抑郁癥可能具有一定的臨床預測價值,并且可在一定程度上反映冠心病PCI治療后抑郁癥的嚴重程度。3.臨床醫(yī)生采用PCI積極診治冠心病的同時,需對患者及時進行有效的心理狀態(tài)評估,盡早進行干預治療,以提高患者生活質(zhì)量。
[Abstract]:Objective: to detect coronary heart disease (CHD) after percutaneous coronary intervention (PCI) after treatment with depression patients serum brain-derived neurotrophic factor (Brain-derived neurotrophic, factor, BDNF) and ghrelin (Ghrelin) level, to investigate the correlation between depression and serum BDNF and Ghrelin levels of coronary heart disease after PCI treatment. Methods: from from 2016 02 to 2016 08 months of treatment in 90 hospitalized patients with coronary heart disease treated with PCI cases of Department of Cardiology, people's Hospital of Gansu Province, to PCI for 3 days before and after the treatment were performed within 3 days of the Hamilton Depression Scale (HAMD) score, according to the HAMD score were divided into depression group with coronary heart disease after PCI treatment (n=40 the non depression group) and PCI (n=50). After treatment by enzyme linked immunosorbent assay (ELISA) detection of serum BDNF and Ghrelin levels, the analysis of the two patients with coronary heart disease after PCI treatment with anti correlation between depression. Results: 1. The depression group sex, depression group and PCI after the treatment of non general clinical data of coronary heart disease after PCI treatment, smoking, age, body mass index, Gensini score, blood pressure, fasting blood glucose, blood lipid, liver function, renal function and baseline data matching, had no statistical significance (P0.05).2.HAMD score value comparison non depression group coronary heart disease after PCI treatment with depression group HAMD score at PCI after treatment was significantly higher than that of PCI (P0.05).3. after treatment, serum BDNF, serum BDNF Ghrelin levels compared with depression group of coronary heart disease after PCI treatment, the level of Ghrelin was significantly lower than that of PCI after the treatment of non depression group.4. different degree of depression between the serum BDNF and Ghrelin levels after PCI treatment of depression with more weight, the lower the level of serum BDNF, Ghrelin (P0.05).5. BDNF in serum, the correlation Pearson correlation analysis of Ghrelin level and HAMD score and the correlation between serum Ghrelin level and BDNF level display , serum BDNF, Ghrelin levels and HAMD scores were negatively correlated (r=-0.711, P0.05; r=-0.711, P0.05), the serum level of Ghrelin was positively correlated with BDNF level (r=0.787, P0.05). Conclusion: depression occurred in 1. patients with coronary heart disease after PCI treatment, indicating that PCI may be the treatment of comorbid depression factor.2. serum BDNF and Ghrelin levels on PCI after treatment with depression may have clinical value in predicting, and to a certain extent, reflect the severity of coronary heart disease PCI.3. clinicians after treatment of depression with PCI positive diagnosis and treatment of coronary heart disease at the same time, the need for timely effective evaluation of the psychological status of patients with early intervention, in order to to improve the quality of life of patients.

【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.4;R749.4

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