首页|体外循环心脏瓣膜置换术患者术后抑郁的危险因素分析

体外循环心脏瓣膜置换术患者术后抑郁的危险因素分析

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目的 分析体外循环(Cardiopulmonary Bypass,CPB)心脏瓣膜置换术患者术后抑郁的危险因素.方法 选取我院2020年1月~2022年12月进行CPB下心脏瓣膜置换术的80例患者纳入研究.于患者术后第3d根据抑郁自评量表(SDS)评分分为未发生抑郁组(SDS评分≥53分)48例及发生组(SDS评分<53分)32例.比较两组患者相关基线资料,检测各组谷氨酸(Glutamic Acid,Glu)及γ-氨基丁酸(γ-Aminobutyric Acid,GABA)浓度并比较,通过ROC及经多因素Logistic回归分析Glu、GABA水平预测抑郁的价值.结果 两组患者相关基线资料比较无显著差异(P>0.05),发生组Glu、GABA均高于未发生组(P<0.05);与正常组比较,发生组T1-T4时点血浆Glu、GABA浓度显著升高(P<0.05);经ROC及经多因素Logistic回归分析,证实Glu>27.833、GABA>174.684是发生抑郁的危险因素,可用于抑郁的预测,曲线下面积分别为0.957、0.711(P<0.05).结论 血浆Glu、GABA浓度升高可能参与了抑郁发生的病理生理过程,可为临床检测抑郁提供参考依据.
Analysis of risk factors for postoperative depression in patients undergoing extracorporeal circulation heart valve replacement surgery
Objective To investigate the risk factors of postoperative depression in patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass(CPB).Methods 80 patients who underwent cardiac valve replacement surgery under CPB in our hospital from January 2020 to December 2022 were selected for the study.On the third day after surgery,the patient was divided into a non-occurring group(SDS score ≥ 53)of 48 cases and an oc-curring group(SDS score<53)of 32 cases based on the Self Rating Depression Scale(SDS)score.Compare the base-line data of two groups of patients,and measure the levels of glutamate acid(Glu)in each group γ-Aminobutyric acid(GABA)and predict the value of Glu and GABA levels in predicting depression through ROC and multivariate logistic regression analysis.Results There was no significant difference in baseline data between the two groups of patients(P>0.05),and Glu and GABA levels in the occurrence group were higher than those in the non-occurrence group(P<0.05);Compared with the normal group,the plasma Glu and GABA concentrations in the occurrence group at T1-T4 time points were significantly increased(P<0.05);Through ROC and multivariate logistic regression analy-sis,it was confirmed that Glu>27.833 and GABA>174.684 are risk factors affecting depression,which can be used for predicting depression.The area under the curve is 0.957 and 0.711,respectively(P<0.05).Conclusion Elevated plasma Glu and GABA concentrations may be involved in the pathophysiological process of depression,providing reli-able reference for clinical detection of depression.

Extracorporeal circulationHeart valve replacement surgeryPostoperative depressionGlutamic acidγ-aminobutyric acid

梁艳红、刘光淼、张玲俐、孙卉

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首都医科大学附属北京潞河医院心外胸外科(北京,101149)

首都医科大学附属北京潞河医院神经内科

体外循环 心脏瓣膜置换术 术后抑郁 谷氨酸 γ-氨基丁酸

2024

国际精神病学杂志
中南大学

国际精神病学杂志

CSTPCD
影响因子:1.426
ISSN:1673-2952
年,卷(期):2024.51(2)
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