COVID-19 大流行期间瓣膜置换术后患者的心理状态与华法林治疗:横断面研究。

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Current Medical Science Pub Date : 2024-08-01 Epub Date: 2024-07-06 DOI:10.1007/s11596-024-2889-8
Xiao-Yan Chen, Sheng He, Zhen Tan, Feng Gao, Hui Jiang, Lu Chen, Li Yang, Yu-Shan Liu, Si-Yi He
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引用次数: 0

摘要

目的:规范华法林抗凝治疗是心脏瓣膜置换术后患者终身治疗的关键。本研究探讨了2019年冠状病毒病(COVID-19)大流行期间焦虑和抑郁的可能风险因素,并分析了心理状态对用药安全的影响:符合条件的患者在门诊就诊时通过文娟星平台接受了网络问卷调查。抑郁采用抑郁自评量表(SDS)进行评估。焦虑通过焦虑自评量表(SAS)进行评估。用莫里斯基量表评估服药依从性:本研究共纳入 309 名患者(年龄为 52.2±11.4 岁)。所有患者的 SDS 得分为(36.9±9.4)分,其中 11 例(3.6%)患者被诊断为抑郁症。所有患者的 SAS 得分为(43.1±9.3)分,其中 71 名患者(23%)被诊断为焦虑症。7 名患者(2.3%)同时患有焦虑症和抑郁症。逻辑回归分析显示,只有月收入是抑郁症的独立影响因素。在焦虑方面,接受过重复手术的患者患焦虑症的风险要高出 2.264 倍,接受过联合用药的患者患焦虑症的风险要高出 2.140 倍。在焦虑、抑郁或两者兼有的患者中,可观察到更多的出血事件和凝血障碍。出现焦虑时,患者的服药依从性更差。然而,抑郁症对服药依从性没有明显影响:结论:在 COVID-19 大流行期间,焦虑和抑郁等精神疾病的检出率较高,严重影响了华法林的用药安全。分析其影响因素,为进一步规范瓣膜置换术后的华法林抗凝治疗提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychological Status and Warfarin Therapy in Patients after Valve Replacement during the COVID-19 Pandemic: A Cross-sectional Study.

Objective: The standardization of warfarin anticoagulant therapy is the key to lifelong treatment for patients after heart valve replacement. The present study explored the possible risk factors for anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic and analyzed the influence of psychological state on medication safety.

Methods: Eligible patients received a web-based questionnaire survey via the Wenjuanxing platform during outpatient visits. Depression was evaluated by the Self-Rating Depression Scale (SDS). Anxiety was evaluated by the Self-Rating Anxiety Scale (SAS). Medication adherence was evaluated by the Morisky scale.

Results: A total of 309 patients (aged 52.2±11.4 years) were included in the present study. The SDS score of all included patients was 36.9±9.4 points, of which 11 (3.6%) patients were diagnosed as having depression. The SAS score of all included patients was 43.1±9.3 points, of which 71 (23%) patients were diagnosed as having anxiety. Seven patients (2.3%) had both anxiety and depression. Logistic regression analysis revealed that only monthly income was an independent influencing factor for depression. Regarding anxiety, patients who underwent repeated operations had a 2.264-fold greater risk, and patients who received combination medication had a 2.140-fold greater risk. More bleeding events and coagulation disorders could be observed in patients with anxiety, depression or both. When anxiety occurred, patients showed worse medication adherence. However, depression had no significant effect on medication adherence.

Conclusion: During the COVID-19 pandemic, the detection rate of mental illnesses such as anxiety and depression was high, which seriously affected the medication safety of warfarin. Analysis of its influencing factors will provide a reference for further standardized regulation of warfarin anticoagulant therapy after valve replacement.

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来源期刊
Current Medical Science
Current Medical Science Biochemistry, Genetics and Molecular Biology-Genetics
CiteScore
4.70
自引率
0.00%
发文量
126
期刊介绍: Current Medical Science provides a forum for peer-reviewed papers in the medical sciences, to promote academic exchange between Chinese researchers and doctors and their foreign counterparts. The journal covers the subjects of biomedicine such as physiology, biochemistry, molecular biology, pharmacology, pathology and pathophysiology, etc., and clinical research, such as surgery, internal medicine, obstetrics and gynecology, pediatrics and otorhinolaryngology etc. The articles appearing in Current Medical Science are mainly in English, with a very small number of its papers in German, to pay tribute to its German founder. This journal is the only medical periodical in Western languages sponsored by an educational institution located in the central part of China.
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