老年患者射血分数保持和轻度降低的心力衰竭与抑郁症的关系

I. Ispas, A. Munteanu, A. Stoica
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We studied 127 patients hospitalized in the Geriatrics Department of the Calarasi County Emergency Hospital, diagnosed with heart failure (HF), being divided into 2 groups: the first group, which included 63 patients with heart failure with mildly reduced ejection fraction and the second, which included 64 patients with heart failure with preserved ejection fraction. Results. The main risk factor present in the studied patients was dyslipidemia, which is present in 90% of patients with a mildly ejection fraction and in 88% of patients with a preserved ejection fraction. Hypertension was also present in 75% of patients in the first group and in 63% of those in the second group. Depression was present in 67% of patients with mildly reduced ejection fraction and in 64% of those with preserved ejection fraction. The degree of depression was higher among women, 11% of those with HF with mildly reduced ejection fraction and 14% of those with preserved ejection fraction had major depression. 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摘要

摘要背景和目的。在出生率下降、成人死亡率高以及医学进步导致预期寿命增加的背景下,现代社会的老年人数量正在加速增加,这对儿童和年轻人不利。心血管疾病在普通人群中越来越常见,是死亡的主要原因,占全球死亡总数的三分之一,心力衰竭是65岁以上患者住院治疗的最常见原因。抑郁症是最常见的精神疾病之一,表现出不同的临床特征,因人而异,与年龄有关,表明抑郁症会导致身体疾病,包括心血管疾病。材料和方法。我们研究了在卡拉拉西县急诊医院老年科住院的127名被诊断为心力衰竭(HF)的患者,将其分为两组:第一组包括63名射血分数轻度降低的心力衰竭患者,第二组包括64名射血分保持的心力衰竭患者。后果研究患者中存在的主要风险因素是血脂异常,90%的轻度射血分数患者和88%的射血分数维持患者存在血脂异常。第一组75%的患者和第二组63%的患者也存在高血压。67%射血分数轻度降低的患者和64%射血分数维持的患者出现抑郁。女性的抑郁程度更高,射血分数轻度降低的HF患者和射血分数保持的HF患者中,11%患有严重抑郁。抑郁症的程度随着年龄的增长而增加,80岁以上的患者主要表现为中重度抑郁症(第一组41%,第二组50%)。NYHA III级心力衰竭患者主要有中度至重度抑郁症:50%的患者射血分数轻度降低,67%的患者射气分数保持不变。结论抑郁症是老年人心力衰竭的一个重要的独立危险因素。由于这两种病理的症状往往相似,抑郁症的诊断可能很困难,这就是为什么应该在所有心力衰竭患者中进行调查的原因。了解老年人息肉病的特点很重要,这通常会给临床医生的诊断和治疗带来问题。
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The Association Between Heart Failure with Preserved and Mildly Reduced Ejection Fraction and Depression in the Elderly Patient
Abstract Background and aim. Modern society is experiencing an accelerated increase in the number of elderly people, to the detriment of children and young adults, in the context of declining birth rates, high adult mortality and increasing life expectancy due to advances in medicine. Cardiovascular diseases are becoming more common in the general population, representing the leading cause of death, being responsible for a third of the total number of deaths worldwide, and heart failure is the most common cause of hospitalization in patients over 65 years. Depression is one of the most common mental illnesses, presents different clinical pictures, which vary from person to person and in relation to age, being shown that there are somatic disorders due to depression, including cardiovascular disease. Materials and method. We studied 127 patients hospitalized in the Geriatrics Department of the Calarasi County Emergency Hospital, diagnosed with heart failure (HF), being divided into 2 groups: the first group, which included 63 patients with heart failure with mildly reduced ejection fraction and the second, which included 64 patients with heart failure with preserved ejection fraction. Results. The main risk factor present in the studied patients was dyslipidemia, which is present in 90% of patients with a mildly ejection fraction and in 88% of patients with a preserved ejection fraction. Hypertension was also present in 75% of patients in the first group and in 63% of those in the second group. Depression was present in 67% of patients with mildly reduced ejection fraction and in 64% of those with preserved ejection fraction. The degree of depression was higher among women, 11% of those with HF with mildly reduced ejection fraction and 14% of those with preserved ejection fraction had major depression. The degree of depression increases with age, patients over 80 years presented predominantly moderate-severe depression (41% of patients in the first group, and 50% in the second). Patients with NYHA class III heart failure had predominantly moderate-to-severe depression: 50% of patients with mildly reduced ejection fraction and 67% of those with preserved ejection fraction. Conclusion. Depression is an important independent risk factor for heart failure in the elderly patients. Due to the fact that the symptoms of the two pathologies are often similar, the diagnosis of depression can be difficult to make, which is why it should be investigated in all patients with heart failure. It is important to understand the peculiarities of the polypathology of the elderly, which often poses problems for the diagnosis and treatment of the clinician.
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