抑郁症对药物坚持,心室功能和心力衰竭再入院的精神心脏学影响:一项回顾性队列研究
Fu-Gang Mao1, Ya-Ling Tang1, Xiao-Yuan Wang2
1Department of Ultrasound Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, Yunnan Province, China.
World journal of psychiatry
|December 8, 2025
概括
在心力衰竭 (HF) 患者中,抑郁症的严重程度独立地预测了心室功能的恶化,药物坚持不佳,以及更高的一年心血管再入院率. 查抑郁症和实施行为干预措施对于改善HF患者的治疗结果至关重要.
科学领域:
- 精神心脏病学心脏病学
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
背景情况:
- 抑郁症是心力衰竭 (HF) 患者常见的并发症,影响生理结果和疾病进展.
- 精神心脏病学领域探索情绪障碍和心血管功能障碍之间的双向关系.
- 了解抑郁症对HF的影响对于改善患者管理和预后至关重要.
研究的目的:
- 评估抑郁症严重程度对HF患者左心室缩功能的影响.
- 调查抑郁症严重程度与HF患者一年心血管再入院率之间的关联.
- 探索抑郁症对HF群体药物坚持的影响.
主要方法:
- 一个回顾性队列研究,涉及160名住院HF患者 (2020年1月 - 2023年12月).
- 使用患者健康问卷-9 (PHQ-9) 评估抑郁症的严重程度;中度至重度定义为PHQ-9 ≥10.
- 用左心室喷射率 (LVEF) 评估心脏功能;用莫里斯基药物坚持度表 (MMAS-4) 评估药物坚持度;跟踪一年心血管再接收.
主要成果:
- 中度至重度的抑郁症与较低的LVEF,较高的NT-proBNP和较差的药物坚持 (MMAS-4分数) 有关.
- 抑郁症的严重程度和较低的坚持与LVEF离院后反向相关.
- 一年心血管再入院发生在30.0%的患者中;高PHQ-9分数,降低的LVEF和缺乏β-阻断剂治疗是再入院的独立预测因素.
结论:
- 抑郁症的严重程度是一个独立的预测器,可以预测心室功能受损,低药物坚持和增加心血管再入院的HF患者.
- 这些发现强调了抑郁症查和行为干预在常规HF护理中的重要性.
- 优化HF的坚持和临床结果需要解决抑郁症的精神心脏学影响.
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