2019 年第 7 期 第 14 卷

老年心肌桥患者合并焦虑抑郁的状况及影响因素分析

Prevalence and influence factors of anxiety and depression in elderly patients with myocardial bridge

作者：王建刚席建堂赵小奎李劲松贺静

英文作者：

单位：710201西安，长庆油田职工医院心内科

英文单位：

关键词：心肌桥；焦虑抑郁

英文关键词：

• 摘要：

• 【摘要】目的    分析老年心肌桥患者合并焦虑、抑郁的状况及影响因素。方法    选取2015年6月至2017年6月在长庆油田职工医院心内科住院的76例老年心肌桥患者为研究对象，均经冠状动脉CT血管造影证实存在心肌桥。分析心肌桥的特点，应用医院焦虑抑郁量表对患者的焦虑抑郁状态进行评价。通过单因素分析及多因素Logistic回归方法分析合并焦虑抑郁的影响因素。结果    本组76例老年心肌桥患者中，65例（85.5%）为浅表型，11例（14.5%）为纵深型。收缩期心肌桥壁血管压缩程度多为轻中度，Nobel分级1级30例（39.5%），2级40例（52.6%），3级6例（7.9%）。发现焦虑47例（61.8%），抑郁20例（26.3%），焦虑并抑郁9例（11.8%）。进行多因素Logistic回归分析，发现心电图异常、纵深型心肌桥、壁血管压缩程度(Nobel分级2～3级)、既往应用硝酸酯类药物是焦虑的危险因素；女性、初中以下文化程度、合并＜50%冠状动脉粥样硬化、年平均就诊次数≥4次、合并心血管外躯体症状是抑郁的危险因素（均P＜0.05）。结论    焦虑、抑郁常与老年心肌桥患者共病，心电图异常、纵深型心肌桥、壁血管压缩程度、既往应用硝酸酯类药物、女性、文化程度低、合并冠状动脉粥样硬化、就诊次数多、合并心血管外躯体症状是其危险因素，关注及干预此类人群心理问题不容忽视。

• 【Abstract】Objective    To analyze the prevalence and risk factors of anxiety and depression in elderly patients with myocardial bridge. Methods    Seventy-six elderly patients with myocardial bridge admitted to Workers′ Hospital of Changqing Oilfield from June 2015 to June 2017 were enrolled. Characteristics of myocardial bridge were measured by coronary CT angiography. Mental state of patients was assessed by Hospital Anxiety and Depression Scale. Influence factors of anxiety and depression were analyzed by univariate and multivariate logistic regression. Results    There were 65 cases（85.5%） of superficial myocardial bridge and 11 cases（14.5%） of deep myocardial bridge; with mostly mild to moderate vascular compression, 30 cases of Nobel stage 1（39.5%）, 40 cases of Nobel stage 2（52.6%） and 6 cases of Nobel stage 3（7.9%）. Prevalence rates of anxiety and depression were 61.8%(47 cases) and 26.3%(20 cases), respectively; prevalence rate of anxiety with depression was 11.8%（9 cases）. Multivariate logistic regression analysis showed that abnormality in electrocardiogram, deep myocardial bridge, Nobel stage of vascular compression 2-3 and medical history of nitrates were risk factors of anxiety; female, poor education（below junior high school）, coronary atherosclerosis(＜50%), annual visits to hospital≥4 and somatic symptoms of cardiovascular disease were risk factors of depression（all P＜0.05）. Conclusions    Anxiety and depression are comorbidities in elderly patients with myocardial bridge. Electrocardiogram abnormality, deep myocardial bridge, vascular compression, use of nitrates, female, poor education, coronary atherosclerosis, frequent visits to hospital and somatic symptoms are the risk factors.