摘要
目的探讨氟西汀联合沙库巴曲缬沙坦治疗慢性心力衰竭(CHF)合并焦虑抑郁的疗效。方法前瞻性选择2023年12月至2025年3月于衡水市第二人民医院就诊的108例慢性心力衰竭合并焦虑抑郁患者为研究对象,采用随机数字表法分成两组,每组54例。对照组采用常规基础干预+沙库巴曲缬沙坦治疗,观察组在对照组治疗方案的基础上加用氟西汀治疗。治疗12周后,比较观察组和对照组患者的心功能、焦虑抑郁程度、睡眠状态、生活质量及不良反应情况。结果治疗后观察组患者的左心室射血分数和6 min步行试验水平高于对照组[(39.84±5.23)%vs(36.32±5.03)%、(388.62±44.32)m vs(351.77±42.47)m],差异有统计学意义(t=3.565、4.411,均P<0.05)。治疗后观察组患者的焦虑自评量表、抑郁自评量表、匹兹堡睡眠质量指数及明尼苏达心力衰竭生活质量问卷评分低于对照组[(29.68±2.45)分vs(36.18±3.02)分、(31.78±2.71)分vs(34.88±2.96)分、(3.21±1.01)分vs(5.12±1.12)分、(41.46±8.31)分vs(48.52±9.16)分],差异有统计学意义(t=-12.283、-5.676、-9.307、-4.195,均P<0.05)。观察组患者的不良反应发生率为12.96%(7/54),对照组为18.52%(10/54),差异无统计学意义(χ^(2)=0.628,P>0.05)。结论氟西汀联合沙库巴曲缬沙坦能够有效改善慢性心力衰竭合并焦虑抑郁患者的心功能,减轻焦虑抑郁程度,提升睡眠及生活质量,且未增加不良反应发生风险。
Objective To investigate the efficacy of fluoxetine combined with sacubitril/valsartan in the treatment of chronic heart failure(CHF)with comorbid anxiety and depression.Methods A total of 108 patients with CHF with comorbid anxiety and depression treated at Hengshui Second People’s Hospital from December 2023 to March 2025 were prospectively selected and randomly divided into two groups,with 54 patients in each group.The control group received conventional foundational intervention plus sacubitril/valsartan,while the observation group received additional fluoxetine on the basis of the control group’s treatment regimen.After 12 weeks of treatment,the cardiac function,anxiety and depression levels,sleep status,quality of life,and adverse reactions were compared between the observation group and the control group.Results After treatment,the left ventricular ejection fraction and 6-minute walk test distance in the observation group were higher than those in the control group((39.84±5.23)%vs(36.32±5.03)%,(388.62±44.32)m vs(351.77±42.47)m,respectively),with statistically significant differences(t=3.565,4.411,both P<0.05).After treatment,the scores of the Self-Rating Anxiety Scale,Self-Rating Depression Scale,Pittsburgh Sleep Quality Index,and Minnesota Living with Heart Failure Questionnaire in the observation group were lower than those in the control group((29.68±2.45)points vs(36.18±3.02)points,(31.78±2.71)points vs(34.88±2.96)points,(3.21±1.01)points vs(5.12±1.12)points,(41.46±8.31)points vs(48.52±9.16)points),with statistically significant differences(t=-12.283,-5.676,-9.307,-4.195,all P<0.05).The incidence of adverse reactions was 12.96%(7/54)in the observation group and 18.52%(10/54)in the control group,with no statistically significant difference(χ^(2)=0.628,P>0.05).Conclusion The combination of fluoxetine and sacubitril/valsartan demonstrated efficacy in improving cardiac function,alleviating anxiety and depression,and enhancing sleep and quality of life in patients with chronic heart failure comorbid with anxiety and depression,without increasing the risk of adverse reactions.
作者
李英
郭秀娟
王琳琳
李明辉
LI Ying;GUO Xiujuan;WANG Linlin;LI Minghui(Department of Cardiology,Hengshui Second People’s Hospital,Hengshui 053000,China;Department of Psychology,Hengshui Second People’s Hospital,Hengshui 053000,China)
出处
《中国药物应用与监测》
2025年第9期1484-1487,共4页
Chinese Journal of Drug Application and Monitoring
关键词
氟西汀
沙库巴曲缬沙坦
慢性心力衰竭
焦虑
抑郁
疗效
fluoxetine
sacubitril/valsartan
chronic heart failure
anxiety
depression
efficacy
