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目的探讨老年冠心病伴抑郁症的临床特点、相关因素及预后。方法选择老年冠心病伴抑郁症患者 5 2例为观察组 ,老年冠心病不伴有抑郁症患者 60例为对照组。对两组患者的临床特点、家庭及社会支持 ,以及Holter监测结果等进行对比分析并随访。结果观察组患者的严重睡眠障碍、焦虑激越、情绪低落、兴趣减退、自觉无用负罪感等症状的发生率与对照组有显著性差异。对照组患者的家庭和睦及社会支持率明显高于观察组。Holter监测显示 ,观察组患者室性心律失常、房性心律失常以及缺血性ST T改变的发生率明显高于对照组 (P <0 .0 5 ,P <0 .0 1)。观察组患者心源性猝死的发生率高于对照组 (P <0 .0 5 )。结论老年冠心病伴抑郁症患者易产生严重睡眠障碍、焦虑激越、情绪低落等症状 ;抑郁症患者心源性猝死率增高 ;良好的家庭及社会支持有利于预防和降低老年冠心病抑郁症的发生
Objective To investigate the clinical features, related factors and prognosis of elderly patients with coronary heart disease and depression. Methods Fifty-two elderly patients with coronary heart disease and depression were selected as the observation group. 60 elderly patients with coronary heart disease without depression were selected as the control group. The clinical features, family and social support, and Holter monitoring results of two groups of patients were compared and followed up. Results The incidence of severe sleep disorders, anxiety, depression, decreased interest, and guiltlessness in observation group were significantly different from those in control group. Family harmony and social support were significantly higher in the control group than in the observation group. Holter monitoring showed that the incidence of ventricular arrhythmia, atrial arrhythmia and ischemic ST T changes in observation group was significantly higher than that in control group (P <0.05, P <0.01). The incidence of sudden cardiac death in observation group was higher than that in control group (P <0.05). Conclusions Elderly patients with coronary heart disease and depression are prone to severe sleep disorders, agitation and depression. The incidence of sudden cardiac death is increased in patients with depression. Good family and social support are helpful to prevent and reduce the occurrence of depression in elderly patients with coronary heart disease