Assessment Of Anxiety And Depression And Influencing Factors Of Patients With Coronary Heart Disease Around The Perioperative Period Of PCI

[Background and objective]With the increase of social development and life pressure,the overall health status of residents showed an obvious trend of sub-health,our residents are generally exposed in the cardiovascular risk factors,which is tend to be younger and younger.According to "China Cardiovascular Disease Report 2016",the challenge is still severe although the prevention and treatment of cardiovascular disease in our country has achieved a preliminary success.The prevalence and mortality of cardiovascular diseases are increasing year by year.About 290 million people suffering from cardiovascular disease,of which about 11 millionare coronary heart disease patients.The "China Health and Family Planning Yearbook(2016)" statistics says,the mortality rate of coronary heart disease in urban and rural residents in China in 2015 will continue the increase of 2012.And the number of patients with cardiovascular diseases in China will go on a rapid growth within the next ten years,Cardiovascular disease will be the major public health issue in China.With the establishment of the social-psychological-biomedical model,the medical workers began to pay more attention into the social and psychological factors on the body and the disease itself,other than easing the uncomfortable of body only,and through the research of social psychological factors and disease,in order to achieve the purpose of improving the quality of patients' life.Percutaneous coronary intervention(PCI) has become an important treatmentof coronary heart disease due to the high security and repeatability,and it can help to alleviate the suffering immediately.But as an invasive operation,PCI might has some negative impact inpatient's psychology and the recovery of disease to a certain degree.In this study we make use of Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)to evaluate the preoperative(1 day)and postoperative(1 week)of anxiety and depression in patients with coronary heart disease who underwent PCI successfully for the first time,compare the changes in mentality before and after PCI and analysis the influencing factors of the changes in psychology around the perioperative period of PCI,such as gender,age,personal life status(smoking or drinking),complications(hypertension,diabetes,hyperlipidemia,etc.),thetype of coronary heart disease,the number of vascular lesion,whether there is residual stenosis or not,the number of stent implantation,BNP level,Left ventricular ejection fraction(LVEF).So we can help the clinicians identify the anxiety and depression status of coronary heart disease patients in time,and provide a basic foundationfor a better treatment and prognosis for patients.[Methods]203 patients were enrolled into this study who received a first PCI therapy in The First Affiliated Hospital of Dalian Medical University from Jun.2017 to Dec.2017.After obtaining informed consent,patients filled in Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)around the perioperative period(1 day before surgery and 1 week after PCI),for any reason who can not done independently,patients have to complete the questionnaire which is read by the researcher,The t-test was used to compare the changes of perioperative anxiety and depression,and the univariate analysis and multivariate linear regression analysis were used to analyze the influencing factors for anxiety and depression.[Result]1.Theanalysisof SAS and SDS score:There were 45 patients(22.2%)who wereunderwent anxiety before PCI,and thenumber of the patients who were underwent depressive were 55(27.1%),and the data reduced to 20(9.9%)and 30(14.8%)after PCI,which can clearly indicated,that anxiety and depression mood were significantly improved compared with that before PCI(P <0.001).2.the results of influencing factors analysis: Sex had a significant effect on the perioperative anxiety and depression of PCI,and the difference was statistically significant(P=0.002,P=0.023).The state of cardiac function(reflected by LVEF)had an effect on preoperative anxiety,with a statistically significant difference(P=0.022).Age,level of education,whether smoking,drinking,with or without hypertension,diabetes,hyperlipidemia,type of coronary heart disease,number of diseased vessels,number of stents implanted,presence or absence of residual stenosis,etc.has no significant differences on anxiety and depression during PCI.[Conclusions]1.Coronary heart disease may lead to anxiety and depression,but PCI can improve this issue.2.Gender is the influencing factor for the changes in anxiety and depression during PCI in patients with coronary heart disease.Female has a higher possibility to be anxious and depress.3.Cardiac function status is the influencing factors for the changes in anxiety and depression during PCI in patients with coronary heart disease.Patients with lower LVEF(LVEF<50%)have a higher possibility to be anxious and depress.