肺动脉高压和慢性血栓栓塞性肺动脉高压患者抑郁和焦虑的患病率和决定因素。

Circulation reports Pub Date : 2025-02-22 eCollection Date: 2025-04-10 DOI:10.1253/circrep.CR-24-0113
Yuzuki Mitsuyama, Ayumi Goda, Kaori Takeuchi, Hanako Kikuchi, Takumi Inami, Kyoko Soejima, Takashi Kohno
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引用次数: 0

摘要

背景:肺动脉高压(PH)患者的抑郁和焦虑筛查尚未得到充分的检查。我们评估了肺动脉高压(PAH)和慢性血栓栓塞性PH (CTEPH)患者的抑郁和焦虑患病率及其决定因素。方法和结果:本横断面研究纳入234例PH患者(年龄57[42-68]岁;75%的女性;多环芳烃/ CTEPH /其他:103/126/5)。总体而言,24%和26%的患者存在抑郁(医院焦虑与抑郁量表[HADS]-抑郁评分≥8)和焦虑(HADS-焦虑评分≥8)。PAH患者抑郁和焦虑患病率分别为18%和19%,CTEPH患者为27%和30%。在PAH患者中,抑郁与较高的平均右房压显著相关(优势比[OR] 1.17;95%置信区间[CI] 1.03-1.32;P=0.013),肺血管阻力较高(OR 1.08;95% ci 1.01-1.16;P=0.034),较低的动脉血氧饱和度(OR 0.89;95% ci 0.80-0.98;P=0.021),肺动脉氧饱和度(OR 0.93;95% ci 0.87-0.99;P=0.020),减少磷酸二酯酶-5抑制剂的使用(OR 0.30;95% ci 0.11-0.86;P = 0.025)。在CTEPH中,抑郁与精神障碍的存在显著相关(OR 4.71;95% ci 1.24-17.90;P = 0.023)。焦虑与上述PAH和CTEPH参数均无显著相关性。结论:基于疾病严重程度和血流动力学预测抑郁和焦虑具有挑战性,因此个体评估和方法至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence and Determinants of Depression and Anxiety in Patients With Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension.

Background: Depression and anxiety screening has not been adequately examined in patients with pulmonary hypertension (PH). We assessed depression and anxiety prevalence and their determinants in pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).

Methods and results: This cross-sectional study included 234 patients with PH (age 57 [42-68] years; 75% female; PAH/CTEPH/other: 103/126/5). Overall, 24% and 26% of patients had depression (Hospital Anxiety and Depression Scale [HADS]-depression score ≥8) and anxiety (HADS-anxiety score ≥8) respectively. Depression and anxiety prevalence was 18% and 19% in PAH and 27% and 30% in CTEPH, respectively. Among patients with PAH, depression was significantly associated with higher mean right atrial pressure (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.03-1.32; P=0.013), higher pulmonary vascular resistance (OR 1.08; 95% CI 1.01-1.16; P=0.034), lower arterial oxygen saturation (OR 0.89; 95% CI 0.80-0.98; P=0.021), pulmonary artery oxygen saturation (OR 0.93; 95% CI 0.87-0.99; P=0.020), and reduced use of phosphodiesterase-5 inhibitor (OR 0.30; 95% CI 0.11-0.86; P=0.025). In CTEPH, depression was significantly associated with the presence of a psychiatric disorder (OR 4.71; 95% CI 1.24-17.90; P=0.023). Anxiety was not significantly associated with any of the aforementioned parameters in PAH and CTEPH.

Conclusions: Predicting depression and anxiety based on disease severity and hemodynamics was challenging, making individual assessments and approaches crucial.

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