摘要目的 分析老年慢性心力衰竭(CHF)患者焦虑、抑郁症状与游离脂肪酸(FFA)的关系. 方法 通过调查问卷对患者进行横断面研究.根据Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)将126例患者根据有无抑郁分为抑郁组94例、无抑郁组32例;根据有无焦虑分为焦虑组48例、无焦虑组78例.分析对应两组FFA水平的差异及FFA与焦虑、抑郁的关系. 结果 老年CHF住院患者焦虑的发生率为38.1％(48例),抑郁为74.6％(94例).焦虑组和抑郁组患者FFA水平均高于无焦虑组和无抑郁组的患者[(559.9±256.2) μmol/L比(393.8±147.8) μmol/L(P＜0.05)、(573.8±264.7)μmol/L比(483.2±225.2)μmol/L(P ＜0.01)];老年CHF患者FFA水平与SAS和SDS得分呈正相关(r=0.214,P＜0.05;r=0.275,P＜0.01);多元逐步回归分析FFA是老年CHF患者焦虑(β=0.074,95％CI:0.024～0.125,P=0.004)和抑郁(β=0.084,95％CI:0.022～0.145,P=0.008)的危险因素. 结论 FFA与老年CHF住院患者焦虑、抑郁相关,是焦虑、抑郁的危险因素.对高FFA的CHF患者应提前进行心理干预减少焦虑和抑郁的发生.

abstractsObjective To analyze whether free fatty acids(FFA)are associated with anxiety and depression in elderly patients with chronic heart failure(CHF).Methods A cross-sectional study was conducted in patients by using questionnaires.According to the Zung Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale(SDS),126 patients were divided into the depression group (n=94),non-depression group (n =32),and anxiety group (n =48),and non-anxiety group (n =78).The difference in FFA levels between the two groups was analyzed.Moreover,the association of FFA with anxiety and depression was analyzed Results The incidence of anxiety in elderly patients with CHF was 38.1％(48 cases),and the incidence of depression was 74.6％ (94 cases).FFA levels were higher in both the anxiety and depression groups than in the non-anxiety and non-depression groups [(559.9 ± 256.2)μmol/L vs.(393.8 ± 147.8) μmol/L,(573.8 ± 264.7)μmol/L vs.(483.2 ± 225.2)μmol/L,P＜0.05 and 0.01)].The FFA level was positively correlated with SAS and SDS in elderly patients with CHF(r=0.214 and 0.275,P＜0.05 and 0.01).Multivariate regression analysis showed that the FFA level was a risk factor for elderly CHF patients with anxiety(β=0.074,95％CI:0.024～0.125,P=0.004)and depression(β=0.084,95％CI:0.022～0.145,P=0.008).Conclusions FFA levels are correlated with anxiety and depression in elderly patients with CHF.The FFA level is a risk factor for anxiety and depression in elderly patients with CHF.Psychological intervention should be carried out early in CHF patients with high levels of FFA to reduce the incidence of anxiety and depression.