摘要
目的探讨抗抑郁药盐酸帕罗西汀片对慢性心衰伴抑郁患者左心室功能及情绪障碍的影响。方法以我院收治86例慢性心衰伴抑郁障碍患者为研究对象,根据住院单双号分为对照组与观察组,每组各43例,患者入院后均予以常规强心药、利尿剂、增强心肌收缩力药物治疗,并采用常规心理护理,观察组在基础治疗上予以盐酸帕罗西汀片治疗,对照组予以安慰剂治疗,两组均用药3个月,疗程结束后复查左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、心输出量(CO),并评估其抑郁程度,使用超声心电图检测干预前后心功能变化,并观察不良反应。结果干预后,两组左心室功能指标LVEDD、LVESD、LVEF较治疗前明显升高,HAMD、HAMA评分明显下降,且干预后观察组LVESD(3.3±0.1)mm、LVEF(54.5±4.7)%,均明显高于对照组(3.2±0.1)mm、(42.6±4.3)%,观察组HAMD、HAMA评分依次是(15.2±4.6)分、(10.2±4.3)分,均明显低于对照组(18.4±4.2)分、(13.5±4.7)分,差异均具有统计学意义(P<0.05);干预后两组心功能指标SV、CO、E/A、CI较干预前显著升高,且观察组心功能指标均明显优于对照组(P<0.05);对照组不良反应总发生率18.60%,观察组9.30%,差异无统计学意义(P>0.05)。结论盐酸帕罗西汀片可有效改善慢性心力衰竭伴抑郁障碍患者左心室功能,缓解抑郁、焦虑情绪,且未增加明显不良反应,临床可予以考虑。
Objective To investigate the effect of antidepressant Paroxetine Hydrochloride Tablets on left ventricular function and emotional disorders in patients with chronic heart failure（CHF）and depression. Methods 86 cases of patients with CHD and depression in our hospital were selected and divided into the control group and the observation group,43 cases in each group. All patients were given the conventional cardiac drugs,diuretics,and drugs for enhancing myocardial contractility,and routine psychological nursing,and on the basis,the observation group was treated with Paroxetine Hydrochloride Tablets and the control group were treated with placebo. Both groups were treated for 3 months. After treatment,the left ventricular end diastolic diameter（LVEDD）,left ventricular end systolic diameter（LVESD）,left ventricular ejection fraction（LVEF）and cardiac output（CO）were determined,and the degree of depression was evaluated. The changes of cardiac function before and after treatment were detected by ECG,and adverse reactions were observed. Results After the intervention,LVEDD,LVESD and LVEF were significantly increased while HAMD and HAMA scores were significantly decreased in the two groups,and the changes of above indexes were more obvious in the observation group than the control group（P〈0.05）. After intervention,SV,CO,E/A and CI were significantly increased（P〈0.05）. After intervention,the cardiac function indexes in the observation group were significantly better than those in the control group. The total incidence of adverse reactions in the control group was 18.60% while that in the observation group was 9.30%（P〈0.05）. Conclusion Paroxetine Hydrochloride Tablets can effectively improve the left ventricular function in patients with CHF and depression. It can relieve depression and anxiety,without increasing adverse reactions.
作者
任阳
姜文娟
谢圆媛
林芳
REN Yang;JIANG Wenjuan;XIE Yuanyuan(Geriatric Department,Affiliated Hospital of Yan＇an University,Yan＇ an 716000,China)
出处
《国际精神病学杂志》
2018年第4期722-725,共4页
Journal Of International Psychiatry
关键词
帕罗西汀
慢性心力衰竭
左心室功能
情绪障碍
Paroxetine
Chronic heart failure
Left ventricular function
Emotional disorders
