Clinical Outcome Of The Study On Coronary Disease With Emotional Disorders

Background and PurposeCoronary atherosclerotic heart disease(referred to as CHD or ischemic heart disease)is a common disease in the elderly,treatment means continuous improvement,including drug therapy,interventional therapy and surgical treatment;the traditional bio-medical-model has been modern bio-psycho-socialmodel replaced,CHD as a kind of psychosomatic disease,has gradually taken seriously by people.Atherosclerosis(AS)is an inflammatory reaction that occurred in the arterial intima,CHD is a lipid deposition in the coronary artery intima,induced intimal inflammation,persistent inflammation reaction can lead to vascular stenosis or occlusion,resulting in myocardial cell ischemia or necrosis of heart disease.Long course and recurrent symptoms,can cause patients with a heavy psychological burden after the illness,the long-term use of drugs after treatment bring heavy economic pressure to patients and the whole family,which making the CHD combined with the prevalence of emotional disorders increased significantly,and anxiety,depression is the most common.Anxiety and depression can cause or aggravate the inflammation of the body,and increase the level of high sensitivity C reactive protein(hs-CRP)and other inflammatory factors in blood.Domestic and foreign studies have reported that high sensitivity C reactive protein and other inflammatory markers are recognized as a powerful predictor of coronary heart disease events,and can predict the incidence of major adverse cardiovascular events(MACE).Emotional disorders in patients with coronary heart disease,atypical clinical symptoms,clinicians in general hospital have the low rate of identification.some patients can not get timely diagnosis,resulting in the treatment process is not smooth,the treatment effect is not ideal,so more and more emotional disorders in patients with coronary heart disease by people's attention,but at present,the pathogenesis of coronary heart disease is not clear.The purpose of this study is to provide routine treatment for patients in acute coronary heart disease,the symptoms of poverty,the level of hs-CRP in blood and emotion detection evaluation group,patients were followed up after discharge,medication compliance,psychological counseling,the incidence of major adverse cardiovascular events between the two groups,and the clinical effect of emotional disorders of coronary heart disease.Participants and MethodsParticipants: Patients with coronary heart disease were in department of Geriatrics in Tai'an Central Hospital from January 2016 to December,through medical treatment standardization,whose symptom improvement is not obvious,and who are selected,a total of 118 patients,aged between 54 to 82 years old.Exclusive criteria: acute myocardial infarction,rheumatic heart disease,pulmonary heart disease,congenital heart disease,renal insufficiency,tumor,infection,hyperthyroidism,senile dementia,psychiatric patients.Methods: First of all,the general condition of patients,biochemical indicators and oral drugs were collected.Patients received standardized medical diagnosis and treatment,whose Symptom improvement were not obvious,were selected into the group,a total of 118 patients.Then,Department of clinical psychology doctor use Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)to evaluate patients,according to the psychological doctor evaluation results,the patients were divided into non mood disorder group(A group)and 63 patients with mood disorder group(B group)55 cases.A and B two groups of hs-CRP and hospitalization time were compared,and all the patients were followed up for 2 months after discharge,and the medication compliance,psychological consultation,major adverse cardiovascular events were compared between the two groups.ResultsThere was no difference between the A group and the B group in the general clinical data(gender,age,work,education level,blood pressure,blood lipid,blood glucose,personal preference and family history of coronary heart disease,etc.);The HAMA score of two groups is [(7.03±3.92)vs(15.18±3.33)] was statistically significant difference(P<0.05),the HAMD scoreis [(6.40±2.79)vs(13.09±3.72)] was statistically significant difference(P<0.05);Hamilton Anxiety Scale(HAMA)score and Depression Scale(MAMD)score was positively correlated(r=0.671,P<0.001);Two groups of hs-CRP concentration was [(3.683±1.578)vs(3.940±1.150)],the difference between the two groups was not statistically significant(P>0.05);There was no significant correlation between HAMA score,HAMD score and hs-CRP(anxiety score: r=0.135,depression score: r=0.083,P>0.05);Length of stay for the two groups [(8.63±2.84)days vs(9.95±2.68)days],the two groups have significant differences;a positive correlation between HAMA score and HAMD score and hospitalization time(anxiety score: r=0.298,depression score r=0.227,P<0.05);Compared the proportion of patients with regular medication,A group than in B group(87.30% vs 69.09%),with statistically significant difference between the two groups(P<0.001);emotional disorder patients(55cases),psychiatric outpatient visits(38 cases),return ratio of 69.09%;The incidence of major adverse cardiovascular events in A group was lower than that in B group(12.70% vs 30.91%)and the difference was statistically significant between the two groups;Poor compliance leads to adverse clinical events in patients.Conclusion1.prolonged hospitalization in patients with coronary heart disease complicated with emotional disorders;2.there was no significant difference in serum hs-CRP level in patients with coronary heart disease combined with emotional disorder and those without mood disorder;3.there was no significant correlation between the score of the scale and the level of serum hs-CRP;4.clinical follow-up showed that CHD patients with mood disorders were worse than those without mood disorder,and clinical events increased.