缺血性慢性心衰合并抑郁症状患者服用草酸艾司西酞普兰的研究

发布时间：2018-09-01 07:55

【摘要】：目的:观察国产草酸艾司西酞普兰对缺血性慢性心力衰竭合并抑郁症状患者内皮功能及心血管事件的影响,进一步评价草酸艾司西酞普兰的临床疗效,并探讨其机制。方法:将100例确诊为慢性缺血性心力衰竭合并抑郁症状患者随机分为对照组(n=48)和治疗组(n=52),两组患者均给予慢性缺血性心力衰竭常规治疗和心理干预,治疗组患者每早加服国产草酸艾司西酞普兰10 mg,两组患者于治疗前及治疗8周末进行汉密尔顿抑郁量表(HAMD)评分,测定肱动脉血流介导的内皮依赖性血管舒张功能(FMD),并记录心绞痛、心力衰竭、急性心肌梗死和恶性心律失常的发生情况。结果:治疗8周后,治疗组与对照组的HAMD评分分别为(7.61±3.32)和(20.27±3.06)分,有统计学显著差异(P0.05);治疗组与对照组的肱动脉血流介导的FMD分别为(4.40±0.52)%和(4.66±0.56)%,有统计学显著差异(P0.01)。治疗组心绞痛发作、急性心肌梗死、急性心力衰竭及恶性心律失常发生率分别为7.69%,0%,3.85%和1.92%,对照组分别为16.67%,4.17%,6.25%和4.17%。两组的心血管事件有统计学差异意义(P0.05)。结论:草酸艾司西酞普兰可以明显改善慢性缺血性心力衰竭合并抑郁症状患者的抑郁状态,改善患者的血管内皮功能,进一步降低心血管事件,且药物安全。
[Abstract]:Aim: to observe the effects of domestic oxalcitalopram on endothelial function and cardiovascular events in patients with ischemic chronic heart failure complicated with depression, to evaluate the clinical efficacy of oxalcitalopram and to explore its mechanism. Methods: 100 patients with chronic ischemic heart failure complicated with depression were randomly divided into two groups: control group (n = 48) and treatment group (n = 52). Both groups were given routine treatment and psychological intervention. The patients in the treatment group were treated with domestic oxalcitalopram 10 mg, every morning and received Hamilton Depression scale (HAMD) scores before and after 8 weeks of treatment. Brachial artery flow mediated endothelium-dependent vasodilation (FMD),) was measured and the occurrence of angina pectoris, heart failure, acute myocardial infarction and malignant arrhythmia was recorded. Results: after 8 weeks of treatment, the HAMD scores of the treatment group and the control group were (7.61 卤3.32) and (20.27 卤3.06), respectively (P0.05), and the FMD mediated by brachial artery blood flow in the treatment group and the control group were (4.40 卤0.52)% and (4.66 卤0.56), respectively (P0.01). The incidence of angina pectoris attack, acute myocardial infarction, acute heart failure and malignant arrhythmia in the treatment group was 7.690.The incidences of acute heart failure and malignant arrhythmia were 3.85% and 1.92%, respectively. In the control group, 16.674.174.176.25% and 4.17%, respectively. There was significant difference in cardiovascular events between the two groups (P0.05). Conclusion: oxalcitalopram can significantly improve the depressive state of patients with chronic ischemic heart failure and depressive symptoms, improve the vascular endothelial function, further reduce cardiovascular events, and drug safety.
【作者单位】：河北医科大学第一医院心内一科;
【基金】：河北省科技厅课题(122777112)
【分类号】：R541.6;R749.4

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