急性主动脉夹层患者抑郁现况及与心理弹性的相关性研究

Current status of depression and its correlation with psychological resilience in patients with acute aortic dissection

摘要

目的 探讨急性主动脉夹层（acute aortic dissection，AAD）患者出院后的抑郁现状及与心理弹性的相关性。 方法 研究对象选取重庆市急救医疗中心胸心外科2023年6月到2024年6月经电话随访问卷调查的AAD患者67例，统计所有患者的性别、年龄、夹层分型、受教育程度、住院时间、出院时间及住院费用等基本资料，同时发放抑郁自评量表（self-rating depression scale，SDS）和心理弹性量表（connor-davidson resilience scale，CD-RISC）原始量表，最终纳入49份有效问卷进行统计。比较不同基本资料变量AAD患者的SDS和CD-RISC评分，同时Pearson相关性分析SDS评分与心理弹性及各维度评分相关性，进一步多元线性回归分析。 结果 AAD患者的抑郁发生率为36.73%。以基本资料作为变量，不同性别和出院时间的患者的SDS评分比较差异有统计学意义（P<0.05），不同性别和文化程度的患者的CD-RISC评分差异有统计学意义（P<0.05）。Pearson相关性分析显示，SDS评分与CD-RISC评分呈现负相关（r=-0.408，P=0.004），SDS评分与心理弹性中力量维度、坚韧维度和乐观维度评分呈现负相关（r=-0.283，-0.319，-0.493；均P<0.05）。乐观维度和抑郁SDS评分之间存在线性回归关系。 结论 AAD患者具有较高的抑郁发生风险，此外患者心理弹性与抑郁状态存在明显负相关性，强化AAD患者心理弹性建设对预防AAD患者抑郁风险具有重要意义。

Abstract

Objective To investigate the current status of depression and its correlation with psychological resilience in patients with acute aortic dissection（AAD） after discharge. Methods This study was conducted among 67 patients with AAD who were treated in Department of Cardiothoracic Surgery，Chongqing Emergency Medical Center，from June 2023 to June 2024 and received telephone follow-up and questionnaire survey，and basic data were collected from all patients，including sex，age，dissection type，educational level，length of hospital stay，discharge time，and hospital costs. Self-Rating Depression Scale（SDS） and Connor-Davidson Resilience Scale（CD-RISC） were distributed，and finally 49 valid questionnaires were included for statistical analysis. SDS and CD-RISC scores were compared between AAD patients with different basic data variables，and the Pearson correlation analysis was used to investigate the correlation of SDS score with psychological resilience and the scores of each dimension. The multiple linear regression analysis was further performed. Results The incidence rate of depression was 36.73% among the patients with AAD. With the basic data as variables，there was a significant difference in SDS score between the patients with different sexes and discharge times（P<0.05），and there was a significant difference in CD-RISC score between the patients with different sexes and educational levels（P<0.05）. The Pearson correlation analysis showed that SDS score was negatively correlated CD-RISC score（r=-0.408，P=0.004），and SDS score was also negatively correlated with the scores of the dimensions of strength，resilience，and optimism in psychological resilience（r=-0.283，-0.319，-0.493，all P<0.05）. There was a linear regression relationship between the dimension of optimism and the SDS score of depression. Conclusion There is a relatively high risk of depression in patients with AAD，and there is a significant negative correlation between psychological resilience and depressive state. Strengthening the construction of psychological resilience in AAD patients is important to prevent the risk of depression in AAD patients.

关键词

急性主动脉夹层 / 抑郁 / 心理弹性 / 相关性

Key words

acute aortic dissection / depression / psychological resilience / correlation

基金资助

重庆市自然科学基金资助项目(CSTB2023NSCQ-MSX1049)

重庆医科大学未来医学青年创新团队资助项目(W0168)