【摘要】 目的 分析不同性别老年冠心病患者经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后的心理状态及相关因素。方法 选择2021年1月至2024年12月齐齐哈尔医学院附属第二医院心内科住院并接受PCI的老年冠心病患者303例，根据性别分为男性组154例，女性组149例。根据7项广泛性焦虑障碍量表女性组又分为焦虑组97例，非焦虑组52例，男性组又分为焦虑组82例，非焦虑组72例；根据9项患者健康问卷女性组又分为抑郁组92例，非抑郁组57例，男性组又分为抑郁组75例，非抑郁组79例。记录各组基本临床资料和心理评估数据，包括总胆固醇（total cholesterol,TC）、三酰甘油（triglyceride,TG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）等，并进行统计分析。结果 女性组躯体症状评分、焦虑、焦虑评分，抑郁和抑郁评分明显高于男性组，差异有统计学意义(P<0.05,P<0.01)。女性患者焦虑组年龄、TC、TG、LDL-C、躯体症状评分明显高于非焦虑组，抑郁组年龄、TC、TG、LDL-C、躯体症状评分明显高于非抑郁组，差异有统计学意义(P<0.05,P<0.01）。男性患者焦虑组年龄、病变支数、支架数量≥2枚、躯体症状评分明显高于非焦虑组，抑郁组年龄、TC、病变支数及支架数量≥2枚明显高于非抑郁组，差异有统计学意义(P<0.05,P<0.01)。二元logistic回归分析显示，年龄、TC、LDL-C、躯体症状评分是老年女性冠心病患者发生焦虑的影响因素，年龄、TC、HDL-C、LDL-C、躯体症状评分是老年女性冠心病患者发生抑郁的影响因素(P<0.05,P<0.01）；年龄、支架数量≥2枚、躯体症状评分是老年男性冠心病患者发生焦虑的影响因素(OR=1.068,95%CI:1.002～1.138,P<0.05;OR=6.458,95%CI:2.807～14.858,P<0.01;OR=1.148,95%CI:1.045～1.262,P<0.01)，年龄、支架数量≥2枚、病变支数是老年男性冠心病患者发生抑郁的影响因素(P<0.01)。结论 冠心病PCI患者女性焦虑和抑郁评分高于男性，不同性别患者影响焦虑和抑郁的影响因素存在部分差异，有效控制危险因素有利于改善冠心病PCI患者预后。更多还原

【Abstract】 Objective To analyze the psychological status and related factors in elderly patients of different genders after percutaneous coronary intervention(PCI) for coronary heart disease(CHD). Methods A total of 303 eligible patients treated in our department from January 2021 to December 2024 were enrolled, and then divided into a male group(154 cases) and a female group(149 cases). Based on the 7-item Generalized Anxiety Disorder Scale, they were assigned into a female anxiety group(97 cases), a female non-anxiety group(52 cases), a male anxiety group(82 cases) and a male non-anxiety group(72 cases). According to the 9-item Patient Health Questionnaire, they were alsocategorized into a female depression group(92 cases), a female non-depression group(57 cases), a male depression group(75 cases) and a male non-depression group(79 cases). The basic clinical data and results of psychological assessment were recorded in each group. Statistical analysis was performed on the indicators, including total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C). Results The female patients had significantly higher scores of physical symptoms, anxiety and depression, and larger proportions of anxiety and depression than the male group(P<0.05, P<0.01). In the female patients, advance age, higher TC, TG and LDL-C levels and somatic symptom score were observed in those with anxiety than those without, and in those with depression group than those without(P<0.05, P<0.01). The male anxiety group exhibited older age, more lesion vessels, larger ratio of ≥2 stents, and higher physical symptom score when compared with the male nonanxiety group, and so were in the male depression group than the male non-depression group(P<0.05, P<0.01). Binary logistic regression analysis showed that age, TC, LDL-C, and somatic symptom score were risk factors for anxiety, and age, TC, HDL-C, LDL-C, and somatic symptom score were risk factors for depression in elderly female CHD patients(P<0.05, P<0.01). For the elderly male CHD patients, age, stents ≥2, and somatic symptom score were risk factors for anxiety(OR=1.068, 95%CI:1.002-1.138, P<0.05; OR=6.458, 95%CI:2.807-14.858, P<0.01; OR=1.148, 95%CI:1.045-1.262, P<0.01), and age, stents ≥2, and more lesion vessels were risk factors for depression(P<0.01). Conclusion The female CHD patients undergoing PCI have higher anxiety and depression scores than the male patients. There are certain differences in the influencing factors for anxiety and depression between genders. Effective control of these risk factors may help improve the prognosis of CHD patients after PCI.更多还原