2021 年第 6 期 第 16 卷

心房颤动症状严重程度与患者及家属发生抑郁的相关性研究

The relationship between severity of atrial fibrillation symptoms and depression of patients and their caregivers 

作者：吴嘉慧李思彤李起帆蒋超黎旭宁曼胡荣杜昕董建增马长生

英文作者：Wu Jiahui Li Sitong Li Qifan Jiang Chao Li Xu Ning Man Hu Rong Du Xin Dong Jianzeng Ma Changsheng

单位：首都医科大学附属北京安贞医院心内科国家心血管疾病临床医学研究中心100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University National Clinical Research Center of Cardiovascular Diseases Beijing 100029 China

关键词：心房颤动；心房颤动症状；抑郁

英文关键词：Atrialfibrillation;Atrialfibrillationsymptoms;Depression

• 摘要：

• 目的 分析心房颤动症状严重程度与患者及家属发生抑郁的关系。方法 选择2020年10月至2021年1月于首都医科大学附属北京安贞医院拟行心房颤动导管消融术治疗的329例非瓣膜性心房颤动患者，同时每位患者连同1位家属入选。收集患者基线资料、心房颤动相关信息、既往史、用药史信息，以及家属基线资料、疾病数量信息。欧洲心律协会（EHRA）症状量表用于评估患者症状严重程度，患者健康问卷抑郁量表（PHQ-9）用于评估患者及家属的抑郁状况，PHQ-9评分≥5分定义为抑郁。Logistic回归用于分析心房颤动症状与患者及家属抑郁的关系。结果 患者及家属PHQ-9评分中位数分别为3（1，6）分和0（0，3）分。117例患者（35.6%）及46例家属（14.0%）PHQ-9评分≥5分。EHRA 3～4级的患者抑郁率明显高于EHRA 1～2级的患者［48.3%（69/143）比25.8%（48/186），P<0.001］；EHRA 3～4级患者的家属抑郁率明显高于EHRA 1～2级患者的家属［18.9%（27/143）比10.2%（19/186），P=0.025］。调整混杂因素后，较重的心房颤动症状（EHRA 3～4级）与患者的抑郁（比值比=2.42，95%置信区间：1.46～4.01，P=0.001）及家属的抑郁（比值比=2.04，95%置信区间： 1.04～4.01，P=0.038）均有关。结论 心房颤动患者及其家属抑郁状态的患病率较高。症状较重的心房颤动患者合并抑郁状态的比例更高，且其家属存在抑郁的可能性也更高。

• Objective  To analyze the relationship between severity of atrial fibrillation (AF) symptoms and depression of patients and their caregivers. Methods From October 2020 to January 2021, 329 patients with non-valvular AF who planned to undergo catheter ablation for AF in Beijing Anzhen Hospital, Capital Medical University were selected. At the same time, a family member of each patient was selected. Baseline data, data related to AF, medical history and medication history of patients, and baseline data and diseases number of caregivers were collected. European Heart Rhythm Association (EHRA) symptom scale was used to assess the severity of symptoms in patients. Patient Health Questionaire-9 items (PHQ-9) was used to assess depression of patients and their caregivers. PHQ-9 score ≥ 5 was defined as depression. Logistic regression was used to analyze the relationship between symptoms of AF and depression of patients and their caregivers. Results The PHQ-9 scores of patients and caregivers were 3(1, 6) and 0(0, 3), respectively. There were 117 cases（35.6%） of patients and 46 cases（14.0%） of caregivers with PHQ-9 score ≥ 5. The depression rate of patients with EHRA grade 3-4 was significantly higher than that of patients with EHRA grade 1-2 ［48.3%（69/143） vs 25.8%（48/186）, P<0.001］; the depression rate of caregivers of patients with EHRA grade 3-4 was significantly higher than that of caregivers of patients with EHRA grade 1-2 ［18.9%（27/143） vs 10.2%（19/186）, P=0.025］. After adjusting for confounders, severe AF symptoms(EHRA grade 3-4) was associated with depression of both patients (odds ratio=2.42, 95% confidence interval: 1.46-4.01, P=0.001) and their caregivers (odds ratio=2.04, 95% confidence interval: 1.04-4.01, P=0.038). Conclusions  The prevalence of depression in patients with AF and their caregivers is high. Patients with severe AF have higher prevalence of depression, and their caregivers are more likely to experience depression.