本文選題：冠心病 + 焦慮　； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:探討焦慮抑郁障礙對(duì)冠心病患者介入治療前后血清高敏C反應(yīng)蛋白的影響及其臨床意義。方法:選擇2016年3月至2016年9月在吉林大學(xué)第一醫(yī)院心內(nèi)科因冠心病住院并擬行冠脈造影的患者71例,由本研究者及助手按照漢密爾頓焦慮量表(HAMA)和漢密爾頓抑郁量表(HAMD)對(duì)研究對(duì)象的心理狀態(tài)進(jìn)行評(píng)價(jià),根據(jù)評(píng)分結(jié)果將行PCI術(shù)的患者分為焦慮抑郁PCI組及非焦慮抑郁PCI組,并將行冠脈造影術(shù)后未行PCI術(shù)的非焦慮抑郁患者作為對(duì)照組。抽取所有研究對(duì)象術(shù)前空腹外周靜脈血測(cè)定血清高敏C反應(yīng)蛋白,并于術(shù)后第一天再次抽取外周靜脈血測(cè)定血清高敏C反應(yīng)蛋白,對(duì)術(shù)前術(shù)后測(cè)得的血清高敏C反應(yīng)蛋白值進(jìn)行比較。結(jié)果:(1)術(shù)前:三組間術(shù)前Hs-CRP水平差異有統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)兩兩組間比較,焦慮抑郁PCI組患者的術(shù)前血清Hs-CRP基礎(chǔ)水平均明顯高于對(duì)照組和非焦慮抑郁PCI組(P0.05),而非焦慮抑郁PCI組患者的術(shù)前血清Hs-CRP水平與對(duì)照組比較無(wú)統(tǒng)計(jì)學(xué)意義。(2)術(shù)后:三組間術(shù)后Hs-CRP水平差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)兩兩組間比較,焦慮抑郁PCI組患者的術(shù)后血清Hs-CRP水平均明顯高于對(duì)照組和非焦慮抑郁PCI組(P0.05),且非焦慮抑郁PCI組患者的術(shù)后血清Hs-CRP水平明顯高于對(duì)照組(P0.05)。(3)同組前后對(duì)比:焦慮抑郁PCI組、非焦慮抑郁PCI組術(shù)后Hs-CRP水平分別(7.760±1.850mg/L;4.909±1.076mg/L),較兩組術(shù)前的血清Hs-CRP水平(3.786±1.473mg/L;2.054±0.950mg/L)明顯升高(P0.01)。對(duì)照組術(shù)前術(shù)后血清Hs-CRP水平則無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:(1)術(shù)前:焦慮抑郁PCI組患者的Hs-CRP水平均明顯高于對(duì)照組及非焦慮抑郁PCI組,提示Hs-CRP水平與焦慮抑郁具有較密切的聯(lián)系,合并焦慮抑郁情緒障礙的冠心病患者體內(nèi)的炎癥反應(yīng)可能更趨于明顯。(2)術(shù)后:冠心病患者PCI組術(shù)后血清Hs-CRP水平較對(duì)照組明顯升高,提示冠心病患者行PCI術(shù)后可能在短期內(nèi)觸發(fā)并加重體內(nèi)炎癥反應(yīng)。(3)同組術(shù)前術(shù)后對(duì)比:合并焦慮抑郁情緒的患者PCI術(shù)后血清Hs-CRP水平較非焦慮抑郁患者PCI術(shù)后升高更為明顯,提示焦慮抑郁情緒可能會(huì)加重冠心病患者PCI術(shù)后體內(nèi)的炎癥反應(yīng)。
[Abstract]:Objective: to investigate the effect of anxiety and depression on serum Gao Min C reactive protein (Gao Min C reactive protein) in patients with coronary heart disease (CHD) before and after interventional therapy. Methods: from March 2016 to September 2016, 71 patients with coronary artery disease were selected from Department of Cardiology, first Hospital of Jilin University. According to the Hamilton anxiety scale (Hama) and Hamilton Depression scale (Hamd), the subjects were evaluated by our researcher and assistant. According to the score, the patients undergoing PCI were divided into anxiety depression PCI group and non-anxiety depression PCI group. Non-anxiety depression patients without PCI after coronary angiography were used as control group. Serum Gao Min C reactive protein (Gao Min C reactive protein) was measured in fasting peripheral venous blood of all subjects before operation, and serum Gao Min C reactive protein (Gao Min C reactive protein) was measured again on the first day after operation. The serum levels of Gao Min C reactive protein (Gao Min C reactive protein) before and after operation were compared. Results: (1) preoperative: there was significant difference in preoperative Hs-CRP level among the three groups (P0.05). By comparison between two groups, The preoperative levels of Hs-CRP in the patients with anxiety and depression PCI were significantly higher than those in the control group and the non-anxiety depression PCI group (P0.05), but the preoperative levels of Hs-CRP in the non-anxiety depression PCI group were not significantly different from those in the control group. (2) postoperative: 3. The levels of Hs-CRP were significantly different between groups (P0.05). By comparison between two groups, The postoperative serum Hs-CRP levels in patients with anxiety and depression were significantly higher than those in control group and non-anxiety depression PCI group (P0.05), and the postoperative Hs-CRP levels in non-anxiety depression PCI group were significantly higher than those in control group (P0.05). The postoperative Hs-CRP levels in the non-anxiety depression PCI group (7.760 鹵1.850 mg / L, 4.909 鹵1.076 mg / L) were significantly higher than those in the two groups (3.786 鹵1.473 mg / L, 2.054 鹵0.950 mg / L) (P0.01). There was no significant difference in serum Hs-CRP levels before and after operation in the control group (P0.05). Conclusion: (1) preoperative levels of Hs-CRP in patients with anxiety and depression in PCI group were significantly higher than those in control group and non-anxiety depression PCI group, suggesting that the level of Hs-CRP was closely related to anxiety and depression. The inflammatory reaction in coronary heart disease patients with anxiety and depression disorder may be more obvious. (2) postoperative: the serum Hs-CRP level in PCI group was significantly higher than that in control group. The results suggest that coronary artery disease may trigger and aggravate the inflammatory reaction in patients with coronary heart disease in a short period of time. (3) the serum levels of Hs-CRP in patients with anxiety and depression after PCI were significantly higher than those in patients with non-anxiety and depression after PCI. (3) the levels of Hs-CRP in patients with anxiety and depression were significantly higher than those in patients with anxiety and depression. The results suggest that anxiety and depression may aggravate the inflammatory response after PCI in patients with coronary heart disease.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.4

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