The Association Between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide With Functional Status in Patients With Heart Failure.
The Association Between Depressive Symptoms and N-Terminal Pro-B-Type Natriuretic Peptide With Functional Status in Patients With Heart Failure.
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抑郁症状与心力衰竭患者的N末端pro-B型纳二肽与功能状态之间的关联。
DOI：
10.1097/jcn.0000000000000470
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Lennie TA
中科院分区：
文献类型：
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作者：
Saleh ZT;Wu JR;Salami I;Yousef K;Lennie TA
N-末端B型利钠肽原（NT-proBNP）和抑郁症状均与心力衰竭（HF）患者的功能状态相关，但尚未研究它们与功能状态的相关性。确定功能状态评分是否随抑郁症状和NT-proBNP水平的变化而变化。我们研究了284例HF患者，根据NT-proBNP水平的中位数分裂和抑郁症状的临界点将其分为4组（贝克抑郁量表≥ 14）：1）低NT-proBNP ≤ 562.5 pg/ml且无抑郁症状，2）低NT-proBNP ≤ 562.5 pg/ml且有抑郁症状，3）高NT-proBNP > 562.5 pg/ml且无抑郁症状，（4）高NT-proBNP > 562.5pg/ml伴抑郁症状。使用杜克活动状态指数评估功能状态。非线性回归表明，在控制年龄、性别、处方抗抑郁药和体重指数后，无抑郁症状的患者的功能状态评分高于（更好）抑郁症状患者的两倍以上，无论NT-proBNP水平如何。在存在抑郁症状的情况下，低NT-proBNP患者的功能状态水平与高NT-proBNP患者无差异。当一起检查时，抑郁症状而不是NT-proBNP水平预测功能状态。无论心力衰竭的严重程度如何，对抑郁症状进行适当的治疗可能会改善功能状态。
N-terminal pro-B type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. To determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): 1) low NT-proBNP ≤ 562.5 pg/ml without depressive symptoms, 2) low NT-proBNP ≤ 562.5 pg/ml with depressive symptoms, 3) high NT-proBNP > 562.5 pg/ml without depressive symptoms, and 4) high NT-proBNP > 562.5 pg/ml with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Adequate treatment of depressive symptoms may lead to better functional status regardless of heart failure severity.