植入心脏永久起搏器对缓慢性心律失常并发焦虑或抑郁的影响

doi:10.6040/j.issn.1671-7554.0.2018.327

摘要/Abstract

摘要： 目的探讨植入心脏永久起搏器对缓慢性心律失常并发焦虑或抑郁的影响,分析缓慢性心律失常并发焦虑或抑郁的相关因素。方法选择缓慢性心律失常门诊患者212例,根据纳排标准最终入组患者198例,根据疾病综合评估及患者治疗意愿分为对照组(n=96例)和起搏器治疗组(n=102例),采集患者基本信息、既往史、血生化指标,行24 h动态心电图、超声心动图检测,完成汉密顿焦虑量表、汉密顿抑郁量表。3个月复诊完成上述检查及问卷。收集资料,对两组资料进行组间及治疗前后对比,并对其进行相关分析。结果植入心脏永久起搏器显著减轻缓慢性心律失常伴发的焦虑和抑郁症状(P<0.001)。焦虑与女性、年龄、夜间惊醒症状、晕厥症状、最长R-R间期、吸烟、饮酒、高血压、糖尿病均呈显著正相关(P均<0.05)。抑郁与女性、年龄、夜间惊醒症状、晕厥症状、糖尿病均呈显著正相关(P均<0.05)。结论植入心脏永久起搏器显著减轻缓慢性心律失常伴发的焦虑或抑郁症状。

关键词: 心脏起搏器, 双心病, 汉密顿量表, 焦虑, 抑郁

Abstract: Objective To investigate the effects of implanted cardiac permanent pacemaker on anxiety or depression associated with bradyarrhythmia, and to explore the related risk factors. Methods A total of 212 outpatients with bradyarrhythmia were selected and according to the inclusion and exclusion criteria 198 patients were finally enrolled. According to the comprehensive assessment and patient willingness, patients were divided into control group(n=96)and pacemaker group(n=102). Each patients basic information, medical history, blood biochemical indexes, 24 h Holter monitoring results, and echocardiography results were acquired, and hamilton anxiety scale and hamilton depression scale were completed. The above examinations and questionnaires were completed again after 3 months. The data were collected and compared. Results The installation of cardiac permanent pacemaker significantly reduced anxiety or depression symptoms associated with bradyarrhythmia(P<0.001). Anxiety was significantly and positively correlated with women, age, wakefulness, syncope, the longest R-R interval, smoking, drinking, hypertension and diabetes(P<0.05). Depression was also remarkably and positively correlated with women, age, wakefulness, syncope and diabetes(P<0.05). Conclusion The implantation of cardiac permanent pacemaker can significantly alleviate symptoms of anxiety or depression associated with bradyarrhythmia.

Key words: Cardiac permanent pacemaker, Heart disease with psychiatric disease, Hamilton Scale, Anxiety, Depression

中图分类号:

R574

赵可通,赵静,Aiyelabowo Faith,王颖. 植入心脏永久起搏器对缓慢性心律失常并发焦虑或抑郁的影响[J]. 山东大学学报 (医学版), 2018, 56(7): 39-45.

ZHAO Ketong, ZHAO Jing, Aiyelabowo Faith, WANG Ying. Effects of implanted cardiac permanent pacemaker on anxiety or depression associated with bradyarrhythmia[J]. Journal of Shandong University (Health Sciences), 2018, 56(7): 39-45.

参考文献

[1] 姜乾金. 心理社会因素与冠状动脉粥样硬化性心脏病[J]. 新医学, 1998, 29(9): 457-458.
[2] 胡大一. 心血管疾病和精神心理障碍的综合管理——“双心医学”模式的探索[J]. 中国临床医生, 2006, 34(5): 2-3.
[3] 牛素贞, 秦连菊, 段和春, 等. “双心医学”对冠心病伴抑郁和焦虑患者心率变异性与心功能的影响[J]. 临床荟萃, 2014, 29(8): 910-911.
[4] 孙静, 陈春. “双心病”的研究进展[J]. 中国医药科学, 2015, 5(19): 26-29.
[5] Rothe AVE, Goette A, Kirchhof P, et al. Recent advances in psychocardiology: Update 2013; mental health in patients with atrial fibrillation: An urgent call for consideration [J]. J Psychosom Res, 2013, 74(6): 560-560.
[6] 赵清珍, 刘刚, 刘超, 等. 不同起搏器植入部位对房室传导阻滞患者情绪状态的影响[J]. 中国全科医学, 2017, 20(18): 2197-2200. ZHAO Qingzhen, LIU Gang, LIU Chao, et al. Effect of different right ventricular pacing sites on emotional state in patients with atrioventricular block after implantation of permanent cardiac pacemaker [J]. Chinese General Practice, 2017, 20(18): 2197-2200.
[7] 张娇, 闫城, 黄芳. Zung氏焦虑抑郁量表测评心血管内科住院患者的适用性分析[J]. 实用预防医学, 2017, 24(8): 909-912. ZHANG Jiao, YAN Cheng, HUANG Fang. Applicability of Zungs Self-Rating Anxiety Scale in evaluating inpatients in department of cardiovascular medicine [J]. Practical Preventive Medicine, 2017, 24(8): 909-912.
[8] Mark Zimmerman MD, Jacob Martin BA, Heather Clark BS, et al. Measuring anxiety in depressed patients: A comparison of the Hamilton anxiety rating scale and the DSM-5 anxious distress specifier interview [J]. J Psychiatr Res, 2017, 93: 59-63. doi: 10.1016/j.jpsychires.2017.05.014.
[9] Zimmerman M, Clark H, McGonigal P, et al. Relationship between the DSM-5 anxious distress specifier and the Hamilton depression rating scale anxiety/somatization factor[J]. J Nerv Ment Dis, 2018, 206(2): 152-154.
[10] 蔡飞, 周果, 王颖, 等. 汉密顿量表评分在心脏神经症诊断中的价值[J]. 山东医药, 2012, 52(15): 57-58.
[11] 张润峰, 胡大一, 高文根, 等. 双心诊疗模式对急性心肌梗死患者预后的影响[J]. 中国当代医药, 2011, 18(25): 15-17. ZHANG Runfeng, HU Dayi, Gao Wengen, et al. Effects of psycho-cardiology treatment model on prognosis in patients with acute myocardial infarction [J]. China Modern Medicine, 2011, 18(25): 15-17.
[12] 刘园园, 卢文秋. “双心医学”模式在慢性心衰伴抑郁障碍患者中的应用[J]. 天津医药, 2014, 42(6): 575-577. LIU Yuanyuan, LU Wenqiu. Application of psycho-cardiology in patients with heart failure complicated with depressive disorder [J]. Tianjin Medical Journal, 2014, 42(6): 575-577.
[13] 孙延宏, 赵一秀, 张鑫, 等. 缓慢性心律失常发生机制与药物治疗的现状[J]. 中国医院药学杂志, 2016, 36(19): 1715-1718. SUN Yanhong, ZHAO Yixiu, ZHANG Xin, et al. Situation of bradyarrhythmia mechanisms and drug treatment [J]. China Journal of Hospital Pharmacy, 2016, 36(19):1715-1718.
[14] Herring N. Autonomic control of the heart: going beyond the classical neurotransmitters [J]. Exp Physiol, 2015, 100(4): 354-358.
[15] Tjong FV, Reddy VY. Permanent leadless cardiac pacemaker therapy: a comprehensive review [J]. Circulation, 2017, 135(15): 1458-1470.
[16] 蒋祥林, 邹飞, 方应权. 中医药治疗缓慢性心律失常的研究进展[J]. 中成药, 2016, 38(7): 1582-1585.
[17] 张聪, 侯平. 中医药治疗缓慢性心律失常症药关系研究[J]. 中医杂志, 2016, 57(14): 1247-1250.
[18] 章轶立, 贾敏, 谢雁鸣, 等. 参附注射液治疗缓慢性心律失常的有效性和安全性研究:随机对照试验的系统评价和Meta分析[J]. 北京中医药大学学报, 2016, 39(7): 595-604. ZHANG Yili, JIA Min, XIE Yanming, et al. Efficacy and safety of Shenfu injection treating bradycardia: a systematic review with meta-analysis of randomized controlled trials[J]. Journal of Beijing University of Traditional Chinese Medicine, 2016, 39(7): 595-604.
[19] 安莉. 通脉复律汤治疗冠心病缓慢性心律失常患者110例的临床效果[J]. 中国医药导报, 2016, 13(18): 165-168. AN li. Randomized controlled clinical observation of Tongmaifulv Decoction in the treatment of bradyarrhythmia in coronary heart disease[J]. China Medical Herald, 2016, 13(18): 165-168.
[20] 许田, 肖平喜, 贾若雅, 等. 病态窦房结综合征患者起搏器植入前后院内焦虑评分的变化[J]. 南京医科大学学报(自然科学版), 2013, 33(9): 1283-1285.
[21] 李森林. 心理干预对起搏器植入术后患者焦虑症状的疗效分析[J]. 中国循环杂志, 2016, 31(1): 52-52.
[22] Mitro P, Kotianova A, Bodnar J, et al. Quality of life and psychological well-being in patients with various pacing modes [J]. Bratisl Lek Listy, 2008, 109(6): 260-266.
[23] 贺建华, 张娜, 龚云涛. 焦虑抑郁共病研究概述[J]. 精神医学杂志, 2010, 23(6): 468-471.
[24] 张毅梅, 周朝当, 王继才. 40例抑郁症患者心身症状及抑郁焦虑共病情况调查[J]. 中国健康心理学杂志, 2012, 20(10): 1464-1465. ZHANG Yimei, ZHOU Chaodang, WANG Jicai. The psychosomatic and anxiety depression comorbid of 40 patients with depression [J]. China Journal of Health Psychology, 2012, 20(10): 1464-1465.
[25] Kucukberber N, Ozdilli K, Yorulmaz H. Evaluation of factors affecting healthy life style behaviors and quality of life in patients with heart disease[J]. Anadolu Kardiyol Derg, 2011, 11(7): 619-626.
[26] Millan-Calenti JC, Maseda A, Rochette S, et al. Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co-existence of both [J]. Int J Geriatr Psychiatry, 2011, 26(10): 1071-1079.

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