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世界核心医学期刊文摘(心脏病学分册) 2006年第4期 37-37页

作者： Mitchell R.H.B. Robertson E. Harvey P.j. 柴大军 Toronto General Hospital EN-7-233 200 Elizabeth St Toronto Ont. M5G 2C4 Canada

Background: Previous research suggests that after coronary artery bypass graft(CABG)surgery, women fare worse than men. This study investigates sex differences in depression during recovery from CABG surgery. Methods: We followed 137 patients(72 men, 65 women)undergoing elective isolated first CABG surgery between july 2003 and April 2004. Patients were interviewed ≤28 days before surgery and between 6 and 12 weeks after surgery. Patients completed a structured diagnostic interview for major depressive disorder(MDD)and the beck Depression Inventory(BDI). Clinical data were retrieved from patient charts. Results: Prevalence of MDD before surgery was 28.2%, but decreased to 16.4%after surgery(P=.038). Women had significantly more depressive symptoms than men pre-CABG, with a mean BDI of 12.5(95%CI 10.6-14.4)for women versus 8.0(95%CI 6.3-9.8)for men(P=.0001), but not post-CABG. There was a significant sex-by-time interaction with depre ssive symptoms in women improving almost 6-fold more than in men, with BDI chan ge scores of 4.1(95%CI 2.0-6.1)for women versus 0.7(95%CI-1.0-2.5)for men(P =.008). The interaction remained significant after adjusting the model for the p redetermined baseline characteristics education, social support, and operative r isk. Conclusions: Women had more depressive symptoms than men pre-CABG, but imp roved to a level comparable to men post-CABG. Women benefited from CABG as much or more than men in terms of their mental health. Preoperative depressive sympt oms should not preclude women from CABG surgery.

关键词：抑郁症状术前男性女性 CABG 性别差异差异(心理学)

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心衰患者的抑郁症状与炎症反应

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 28-28页

作者： Ferketich A. K. Ferguson j. P. Binkley P. F. 宁宁 Dr. Ohio State University School of Public Health B-116 Starling-Loving Hall 320 West 10th Avenue Columbus OH 43210 United States

Background: Psychological depression has been linked to heart failure, both an antecedent to and as a risk factor for poor outcomes among patients with existing heart failure. Elevated levels of proinflammatory cytokines have been proposed as a possible physiological link between the 2 conditions. The objective of this study was to examine the proinflammatory cytokines interleukin(IL)-6, IL-1β, and tumor necrosis factor alpha(TNFα) in heart failure patients with and without elevated symptoms of depression. Methods: Thirty-two heart failure patients were recruited from an outpatient heart failure clinic. Depressive symptoms were measured with the beck Depression Inventory(BDI), and a patient was classified as having elevated symptoms of depression if he/she scored ≥10. The cognitive affective subscale score of the BDI, which measures depressed mood independent of physical symptoms, was also examined. Results: In the multiple linear regression models controlling for age, sex, smoking, and antidepressant medication use, there was no relation between BDI score and IL-6(P=.7612) or IL-1β(P=.8261). However, there was a statistically significant positive relation between BDI score and TNFα(P=.0374). There was also a significant relation between an elevated cognitive-affective score and TNFα(P=.0322) but no association with IL-6(P=.8593) or IL-1β(P=.3737). Conclusions: The association between TNFαand the cognitive-affective subscale, which eliminates the physical signs and symptoms that are shared by depression and heart failure, demonstrates a depression-specific activation of proinflammatory cytokines that may promote disease progression and mortality in patients with heart failure.

关键词：心衰患者抑郁症状肿瘤坏死因子-α(TNF-α) 炎症反应细胞因子白细胞介素 beck抑郁量表细胞因子水平不良预后量表评分 IL-1β

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出生前使用倍他米松:纳入随机对照试验31年后的心理功能和健康相关生活质量

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世界核心医学期刊文摘（神经病学分册） 2006年第2期2卷 1-1页

作者： Dalziel S.R. Lim V.K. Lambert A. j.E. Harding 郭俊 Liggins Institute University of Auckland Auckland New Zealand

Objectives: To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood. Design: Followup of the first and largest double blind, placebo controlled, randomised trial of a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. Setting: Tertiary obstetric hospital in Auckland, New Zealand. Participants: 192 adult offspring, mean age 31 years, of mothers who took part in a randomised controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (87 exposed to betamethasone and 105 exposed to placebo). Interventions: Mothers received two doses of betamethasone or placebo 24 hours apart. Main outcome measures: Cognitive functioning assessed with Wechsler abbreviated scale of intelligence; working memory and attention assessed with Benton visual retention test, paced auditory serial addition test, and Brown attention deficit disorder scale; psychiatric morbidity assessed with beck depression inventory II, statetrait anxiety inventory, and schizotypy traits questionnaire; handedness assessed with Edinburgh handedness inventory; health related quality of life assessed with short form 36 health survey. Results: No differ ences were found between groups exposed to betamethasone and placebo in cognitiv e functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life. Conclusions: Prenatal exposure to a single course of betamethasone does not alter cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health related quality of life in adulthood. Obstetricians should continue to use a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome.

关键词：健康相关生活质量随机对照试验倍他米松心理功能出生前新生儿呼吸窘迫综合征 1年后安慰剂对照预防药物受试者

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脑中风后相关生活质量

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世界核心医学期刊文摘（神经病学分册） 2005年第2期1卷 47-47页

作者： Moon Y. S. Kim S. j. Kim H. C. D. H. Kim 王晓琳 Department of Psychiatry Hallym University Coll. Med. Chunchon Sacred Heart H. Chunchon South Korea

The relationship between lesion location and quality of life (QOL) in stroke p atients has not yet been clearly revealed.The present study was undertaken to in vestigate the clinical and anatomical correlates which can predict future QOL in stroke patients. The study subjects consisted of 69 consecutive patients with i schemic stroke who were followed up 2 months after the stroke event at the strok e unit. Quality of life was evaluated during the 2 month follow up period after the stroke. Baseline information or data including clinical and anatomical corr elates (beck Depression Inventory, beck Anxiety Inventory, Barthels Index, MRI data) at the time of the stroke event were collected by performing a review of each patients chart and research data files. Severe subcortical gray matter le sion and depressive symptoms in the acute phase of stroke were of importance in predicting low QOL 2 months after stroke.

关键词：脑中风生活质量脑缺血性中风皮质下中风急性期病案分析焦虑量表

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