| BackgroundThe development of clinical medicine has experienced three era, including experience based medicine、experimental medicine、holistic medicine.Now it’s converting to the socio-psycho-biological model.The disease intervention model is also converting from the main intervention of downstream end-stage disease to the main intervention of upstream multiple psychological behavior risk factors. As one of the behavioral risk factors for coronary heart disease, depression is an independent risk factor for cardiovascular mortality and morbidity. Patients with coronary heart disease and depression comorbidity may cause many adverse effects, such as increased medical costs, increased health service utilization, reduced quality of life,etc. Currently, coronary angiography and percutaneous coronary intervention has become one of the main clinical diagnosis or therapy measures of coronary heart disease. Compared with coronary artery bypass surgery, it has the advantages of no need for general anesthesia,less pain,and shorter hospitalization time.But as an invasive examination and treatment there might be risks that can bring suffering and inconvenience for patients.But the impact of percutaneous coronary intervention on depression symptoms in patients with coronary heart disease is still unclear.ObjectiveTo investigate the impact of percutaneous coronary intervention on depressive symptoms in patients with coronary heart disease. Which would provide theoretical basis of psychological behavior intervention for CHD patients.MethodsAccording to the inclusion and exclusion criteria,a total of 232patients with coronary heart disease, who had undergone coronary angiography from June 2013 to February 2014, were included in this study. Patients were subdivided into PCI(n=107) and non-PCI(n=125) groups.All subjects were administered a standardized questionnaire that provided information about their sex,age,height,weight,smoking and drinking history, history of hypertension, diabetes and chronic kidney disease.And record the laboratory test results and the measurement of left ventricular ejection fraction.Then completed the 17-item Hamilton’s Depression Scale(HAMD), at the baseline and pre-discharge, to assess the depressive symptoms.All data were analyzed by SPSS(version 18.0).Results:(1).Eventually,a total of 232patients with coronary heart disease were enrolled in the study. Base on angiography,125 cases were assigned to the non-PCI group, and 107 cases were assigned to the PCI group. The demographic and clinical characteristics were no significant difference (P>0.05)(2).Using an independent t-test, we found that patients with PCI had greater mean platelet volume (10.62±1.02vs.10.25±1.13, P<0.05), greater triglyceride levels (1.70±1.02vs.1.45±0.52,P<0.05),greater total cholesterol levels(4.67±1.14vs.4.23±0.89, P <0.05), greater low density lipoprotein levels (2.72±0.70vs.2.48±0.60, P<0.05), and lower mean LVEF levels ((64.23±7.35)%vs.(66.30±6.37)%, P<0.05).No relevant differences in other baseline laboratory characteristics.(3).The baseline HAMD scores were not statistically different between the two groups(PCIvs.non-PCI;12.14±5.00 vs.11.14±4.74,P>0.05), but the PCI group had higher pre-discharge HAMD score(13.73±5.24vs.10.74 ±4.45, P<0.05).(4).By a multivariate logistic regression analysis, The mean difference of HAMD score between the baseline and pre- discharge was higher in patients with PCI (OR:2.033; 95%CI: 1.380-2.686, P<0.05)ConclusionsPCI is one of the risk factors of developing depressive symptoms in patients with coronary heart disease during hospitalization; We should pay more attention on the management of PCI related depressive symptoms in patients with coronary heart disease. |
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