抑郁障碍与急性冠脉综合征患者生活质量的真实临床实践

E. Konstantinova, E. A. Koroleva, A. G. Popova, E. Popov, D. A. Anichkov, A. Svet, A. Nesterov, M. Gilyarov
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In Group I the score on SDS was higher or equal to 50 (depression) in 18 % of cases: 15 % female and 3 % male patients (p <0.05). The average score on SDS was notably higher in women than in men (p <0.05). In Group 2 depression was detected in 27 % of cases, without gender differences. The average level of depression was higher in older age groups, both in men and women, in patients with ACS and without ACS. A negative correlation was established for the indicators of SDS and SF-36: in Group 1 r = –0.62, p <0.05, in Group 2 r = –0.76, p <0.05. In Group 1 indicators of health physical component (SF-36) among women were: physical functioning 50, role functioning 34, general health 51, in men: 80, 58 and 63 respectively (p <0.05). In Group 2 these indicators significantly differed only in physical functioning: 60 female and 72 male. In Group 1 depression was observed in 2 % of working and in 30 % of non-working patients (p <0.05); in Group 2: 0 and 34 % respectively. In Groups 1 and 2 depression was found in 10 and 5 % among married, in 31 and 43 % among unmarried patients (p <0.05). In Group 1 depression was detected in 31 % among patients with diabetes, in 12 % – without diabetes (p <0.05). The other analyzed diseases did not have a significant effect on the de pression score.Conclusions. The presence of ACS was associated with depressive disorders in women. At the same time, the severity of depressive disorders was inversely correlated with the quality of life. In women with ACS, the physical component and the psychological component of health on the quality of life scale are significantly lower in comparison with men. In addition, the absence of work and marriage negatively affected the prevalence of depressive disorders among all examined patients. And the presence of diabetes mellitus was associated with a higher level of depression among patients with ACS. 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To study the prevalence of depressive disorders using Zung Self-rating Depression Scale (SDS) in patients with acute coronary syndrome (ACS) in the daily work of the Regional Vascular Center in various gender and social subgroups and to compare their severity with the life quality level.Materials and Methods. The survey included 116 (57 female and 59 male) patients, admitted to Regional Vascular Center with ACS from March to November 2020 (Group 1), and 49 patients hospitalized with other cardiological pathology (Group 2), who made up a comparison group comparable in gender, age, presence of diabetes mellitus, heart attack and stroke in anamnesis.Results. In Group I the score on SDS was higher or equal to 50 (depression) in 18 % of cases: 15 % female and 3 % male patients (p <0.05). The average score on SDS was notably higher in women than in men (p <0.05). In Group 2 depression was detected in 27 % of cases, without gender differences. 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引用次数: 0

摘要

客观的应用Zung抑郁自评量表(SDS)研究不同性别和社会亚组区域血管中心日常工作中急性冠状动脉综合征(ACS)患者的抑郁障碍患病率,并将其严重程度与生活质量水平进行比较。材料和方法。该调查包括116名(57名女性和59名男性)患者,他们于2020年3月至11月因急性冠脉综合征入住区域血管中心(第1组),49名因其他心脏病住院的患者(第2组),他们构成了一个在性别、年龄、糖尿病、心脏病发作和中风记忆方面具有可比性的对照组。后果在第一组中,18%的患者的SDS得分高于或等于50(抑郁症):15%的女性和3%的男性患者(p<0.05)。女性的SDS平均得分显著高于男性(p>0.05)。在第二组中,27%的患者检测到抑郁症,没有性别差异。老年组、男性和女性、ACS患者和非ACS患者的平均抑郁水平较高。SDS和SF-36指标呈负相关:第1组r=-0.62,p<0.05;第2组r=-0.76,p<0.05。在第1组中,女性的健康身体成分指标(SF-36)为:身体功能50,角色功能34,总体健康51,男性分别为:80,58和63(p<0.05)。在第2组中,这些指标仅在身体功能方面存在显著差异:女性60,男性72。在第1组中,2%的工作患者和30%的非工作患者观察到抑郁症(p<0.05);第2组分别为0和34%。在第1组和第2组中,已婚患者中有10%和5%的人患有抑郁症,未婚患者中有31%和43%患有抑郁症(p<0.05)。在第一组中,糖尿病患者中有3.1%患有抑郁症,非糖尿病患者中12%患有抑郁症(p<0.05)。其他分析的疾病对抑郁症评分没有显著影响。结论。ACS的存在与女性的抑郁障碍有关。同时,抑郁障碍的严重程度与生活质量呈负相关。在患有急性冠脉综合征的女性中,在生活质量量表上,健康的身体成分和心理成分明显低于男性。此外,在所有接受检查的患者中,没有工作和婚姻对抑郁障碍的患病率产生了负面影响。在ACS患者中,糖尿病的存在与较高的抑郁水平相关。有必要为以下ACS和抑郁症患者亚组——生活质量低的失业和未婚女性、老年患者、糖尿病患者——制定和实施专门的康复计划。
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Depressive disorders and quality of live in patients with acute coronary syndrome in real clinical practice
Objective. To study the prevalence of depressive disorders using Zung Self-rating Depression Scale (SDS) in patients with acute coronary syndrome (ACS) in the daily work of the Regional Vascular Center in various gender and social subgroups and to compare their severity with the life quality level.Materials and Methods. The survey included 116 (57 female and 59 male) patients, admitted to Regional Vascular Center with ACS from March to November 2020 (Group 1), and 49 patients hospitalized with other cardiological pathology (Group 2), who made up a comparison group comparable in gender, age, presence of diabetes mellitus, heart attack and stroke in anamnesis.Results. In Group I the score on SDS was higher or equal to 50 (depression) in 18 % of cases: 15 % female and 3 % male patients (p <0.05). The average score on SDS was notably higher in women than in men (p <0.05). In Group 2 depression was detected in 27 % of cases, without gender differences. The average level of depression was higher in older age groups, both in men and women, in patients with ACS and without ACS. A negative correlation was established for the indicators of SDS and SF-36: in Group 1 r = –0.62, p <0.05, in Group 2 r = –0.76, p <0.05. In Group 1 indicators of health physical component (SF-36) among women were: physical functioning 50, role functioning 34, general health 51, in men: 80, 58 and 63 respectively (p <0.05). In Group 2 these indicators significantly differed only in physical functioning: 60 female and 72 male. In Group 1 depression was observed in 2 % of working and in 30 % of non-working patients (p <0.05); in Group 2: 0 and 34 % respectively. In Groups 1 and 2 depression was found in 10 and 5 % among married, in 31 and 43 % among unmarried patients (p <0.05). In Group 1 depression was detected in 31 % among patients with diabetes, in 12 % – without diabetes (p <0.05). The other analyzed diseases did not have a significant effect on the de pression score.Conclusions. The presence of ACS was associated with depressive disorders in women. At the same time, the severity of depressive disorders was inversely correlated with the quality of life. In women with ACS, the physical component and the psychological component of health on the quality of life scale are significantly lower in comparison with men. In addition, the absence of work and marriage negatively affected the prevalence of depressive disorders among all examined patients. And the presence of diabetes mellitus was associated with a higher level of depression among patients with ACS. It is necessary to develop and implement specialized rehabilitation programs for the following subgroups of patients with ACS and depression – unemployed and unmarried women, with a low level of quality of life, elderly patients, patients with diabetes mellitus.
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