【摘要】：目的:觀察國產(chǎn)草酸艾司西酞普蘭對缺血性慢性心力衰竭合并抑郁癥狀患者內(nèi)皮功能及心血管事件的影響,進一步評價草酸艾司西酞普蘭的臨床療效,并探討其機制。方法:將100例確診為慢性缺血性心力衰竭合并抑郁癥狀患者隨機分為對照組(n=48)和治療組(n=52),兩組患者均給予慢性缺血性心力衰竭常規(guī)治療和心理干預(yù),治療組患者每早加服國產(chǎn)草酸艾司西酞普蘭10 mg,兩組患者于治療前及治療8周末進行漢密爾頓抑郁量表(HAMD)評分,測定肱動脈血流介導(dǎo)的內(nèi)皮依賴性血管舒張功能(FMD),并記錄心絞痛、心力衰竭、急性心肌梗死和惡性心律失常的發(fā)生情況。結(jié)果:治療8周后,治療組與對照組的HAMD評分分別為(7.61±3.32)和(20.27±3.06)分,有統(tǒng)計學(xué)顯著差異(P0.05);治療組與對照組的肱動脈血流介導(dǎo)的FMD分別為(4.40±0.52)%和(4.66±0.56)%,有統(tǒng)計學(xué)顯著差異(P0.01)。治療組心絞痛發(fā)作、急性心肌梗死、急性心力衰竭及惡性心律失常發(fā)生率分別為7.69%,0%,3.85%和1.92%,對照組分別為16.67%,4.17%,6.25%和4.17%。兩組的心血管事件有統(tǒng)計學(xué)差異意義(P0.05)。結(jié)論:草酸艾司西酞普蘭可以明顯改善慢性缺血性心力衰竭合并抑郁癥狀患者的抑郁狀態(tài),改善患者的血管內(nèi)皮功能,進一步降低心血管事件,且藥物安全。
[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 鹵3.32) and (20.27 鹵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 鹵0.52)% and (4.66 鹵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.
【作者單位】： 河北醫(yī)科大學(xué)第一醫(yī)院心內(nèi)一科;
【基金】：河北省科技廳課題(122777112)
【分類號】：R541.6;R749.4

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