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目的观察住院冠心病患者出院后焦虑和抑郁状况的动态变化。方法入选2007~2009年住院并经冠状动脉造影(CAG)确诊的冠心病患者1116例,在CAG或支架植入后2 d内选用Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)对入选患者进行心理测评。在患者出院后1年通知其门诊回访,再次进行SAS和SDS量表的测评。结果共有361例(32.3%)患者接受了门诊随访,收回有效问卷361份。平均随访时期为患者出院后(14.8±4.3)个月。回访时患者SAS、SDS标准分显著低于其住院时的基线值(P<0.01),但仍显著高于国内标准常模分值(P<0.01)。焦虑和抑郁的症状患病率显著低于住院时各自的症状患病率(P<0.01),其严重程度也较住院时显著下降。女性患者、心肌梗死患者回访时的焦虑和抑郁症状患病率与住院时无显著差异。基线SDS评分、既往心肌梗死史与门诊随访依从性负相关。结论国人住院冠心病患者出院后1年焦虑和抑郁状况显著改善,但仍未恢复至正常人群水平;女性患者和心肌梗死患者在出院后1年焦虑和抑郁状况无显著改善。
Objective To observe the dynamic changes of anxiety and depression in hospitalized patients with coronary heart disease after discharge. Methods A total of 1116 CHD patients admitted to hospital from 2007 to 2009 and confirmed by coronary angiography (CAG) were included in this study. The Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS) Psychological evaluation of selected patients. One year after the patient was discharged from the hospital, the clinic was informed of the visit and the SAS and SDS scales were again evaluated. Results A total of 361 patients (32.3%) received outpatient visits and 361 valid questionnaires were returned. The average follow-up period was 14.8 ± 4.3 months after discharge. At the return visit, the SAS and SDS scores were significantly lower than those at hospitalization (P <0.01), but still significantly higher than the national standard norm (P <0.01). The prevalence rates of anxiety and depression were significantly lower than those of the hospitalized patients (P <0.01), and their severity was significantly lower than that of hospitalization. There was no significant difference in the prevalence of anxiety and depression among female patients and MI patients at the time of visit. Baseline SDS score, previous history of myocardial infarction and follow-up obey negative correlation. CONCLUSIONS: The anxiety and depression status of coronary heart disease patients after hospital discharge in one year have significantly improved, but have not recovered to the normal population level. There is no significant improvement in anxiety and depression status of female patients and myocardial infarction patients one year after discharge from hospital.