摘要
目的:观察伴有焦虑抑郁症状的急性心肌梗死患者加用氟西汀干预的疗效。方法:于2001-01/2003-12选择重庆医科大学附属第一医院住院的急性心肌梗死患者44例为观察对象,符合1997年WHO缺血性心脏病诊断标准。所有患者有急性心肌梗死症状、失眠、乏力、焦虑不安、消极绝望及不同程度焦虑抑郁症状,经汉密顿抑郁量表评分,总分>35分22例,20～35分22例。44例患者随机分两组,抑郁对照组19例,男10例,女9例,年龄45～78岁,平均(56±6)岁,前壁心肌梗死15例,下壁4例;抑郁干预组25例,男18例,女7例,年龄32～7l岁,平均(62±12)岁,前壁心肌梗死15例,下壁10例。两组患者均在抗心肌缺血常规治疗的基础上,抑郁干预组给予氟西汀胶囊口服,20mg/d,连服1个月,抑郁对照组不用任何抗抑郁药物,而给予施尔康片口服,l片/d,连服1个月。结果:纳入患者44例,均进入结果分析。①治疗前后汉密顿抑郁量表评分结果:抑郁对照组自觉症状无明显好转,抑郁干预组抑郁症状好转率为90%。抑郁干预组治疗前后比较差异非常显著[治疗前后分别为(30.65±5.98),(15.01±4.47)分,P<0.01],抑郁对照组与抑郁干预组治疗后比较差异显著[抑郁对照组、抑郁干预组分别为(28.56±6.35),(15.01±4.47)分,P<0.01)。②治疗前后临床情况对比:抑郁对照组发生心肌再梗死、梗死后心绞痛、心力衰竭、心性死亡分别为5,8,4,1例,抑郁干预组分别为3,3,3,0例,抑郁干预组明显优于抑郁对照组。结论:氟西汀干预治疗提高急性心肌梗死的疗效,改善焦虑、抑郁症状。
AIM： To observe the interventional effects of fluoxetine on patients with acute myocardial infarction （AMI） with anxiety and depression,
METHODS： Forty-four AMI inpatients, who were .accorded with the diagnostic standard for ischemic heart disease set by WHO in 1997, were selected from the First Affiliated Hospital of Chongqing University of Medical Sciences between January 2001 and December 2003, and they all had the symptoms of acute myocardial infarction, insomnia, hypodyuamia, despair, anxiety-depression of different degree. The total score of Hamilton rating scale for depression （HAMD） was 〉 35 points in 22 cases, 20-35 points in 22 cases. The 44 patients were randomly divided into depression control group [n=19, 10 males and 9 females aged 45-78 years with an average of （56±6） years： including 15 cases of anterior myocardial infarction and 4 eases of inferior myocardial infarction] and depression interventional group [n=19, 18 males and 7 females aged 32-71 years with an average of （62±12） years; including 15 cases of anterior myocardial infarction and 10 cases of inferior myocardial infarction]. On the basis of route treatment, the patients in the depression interventional group were treated with oral administration of fluoxetine capsule （20 mg per day） for 1 month continuously, and those in the depression control group were not given any antidepressants, but given oral administration of Shierkang tablets, one table a day for 1 month continuously.
RESULTS： All the 44 patients were involved in the analysis of results. （1） HAMD score before and after treatment： The patients in the depression control group felt that the symptoms did not obviously turn better, and the rate of turn better of depressive symptom in the depression interventional group was 90%. The HAMD scores had very significant differences in the depression interventional group before and after treatment [（30.65 ±5.98）, （15.01±4.47） points, P 〈 0.01], and the scores were significantly different between the depression control group and depression interventional group after treatment [（28.56±6.35）, （15.01±4.47） points, P 〈 0.01]. （2） Clinical status before and after treatment： Myocardial reinfarction, angina after infarction, heart failure and cardiac death occurred in 5, 8, 4 and 1 case in the depression interventional group, but in 3, 3, 3 and 0 case in the depression control group respectively, and the clinical status was superior in the depression interventional group than in the depression control group.
CONCLUSION： Fluoxetine can improve the interventional effects on AMI and improve the symptoms of anxiety and depression.
出处
《中国临床康复》
CSCD
北大核心
2006年第14期16-17,共2页
Chinese Journal of Clinical Rehabilitation
