抗抑郁治疗对老年高血压合并抑郁患者血压和生命质量的影响  

Investigation of the influence of antidepression therapy on blood pressure and quality of life in elderly patients both with hypertension and depression

作　　者：马丽娜[1] 冯明[1] 李耘[1] 

机构地区：[1]首都医科大学宣武医院综合科,北京100053

出　　处：《中华临床医师杂志（电子版）》2012年第20期113-117,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：北京市卫生局保健科研课题资助项目(京09-05);卫生部公益性行业科研专项基金(201002011)

摘　　要：目的了解抗抑郁治疗对老年高血压合并抑郁患者血压和生命质量的影响。方法 2008年8月至2011年3月对我院内科67例老年高血压合并抑郁的住院患者进行调查,在常规降压治疗的基础上随机分为对照组(氨氯地平片5mg/d)和治疗组(氨氯地平片5mg/d和西酞普兰20mg/d)两组,治疗3个月。比较两组治疗前后24h收缩压(24hSBP)、24h舒张压(24hDBP)、白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)和SF-36量表评分的变化。结果经治疗后与对照组相比,治疗组的24hSBP[(128.74±3.79)mmHgvs.(139.42±10.19)mmHg]、24hDBP[(72.10±7.65)mmHgvs.(78.64±8.03)mmHg]、dSBP[(130.81±4.50)mmHgvs.(143.39±12.32)mmHg]、dDBP[(76.03±9.46)mmHgvs.(81.53±9.20)mmHg]、nSBP[(126.94±3.69)mmHgvs.(136.53±9.03)mmHg]、nDBP[(68.52±6.89)mmHgvs.(75.44±7.57)mmHg]明显降低,差异有统计学意义(P均<0.01);生命质量除生理功能之外其余各维度均升高(生理机能70.84±9.90vs.62.31±10.16,躯体疼痛74.71±8.51vs.63.33±8.48,总体健康62.19±8.39vs.50.64±7.07,活力64.03±8.26vs.56.11±6.82,社会功能70.94±6.94vs.62.92±7.46,情感职能70.32±6.93vs.62.14±8.18,心理健康69.94±6.44vs.61.69±8.83,总分68.70±3.29vs.60.40±3.40,均P<0.01)。结论对老年高血压合并抑郁患者在降压治疗的同时要重视抗抑郁治疗。Objective To explore the influence of antidepression therapy on blood pressure and quality of life in elderly patients both with hypertension and depression.Methods A total of 67 elderly patients with hypertension and depression in the department of internal medicine of Xuanwu hospital during August 2008 and March 2011 were randomly divided into two groups based on the antihypertensive therapy:control group(amlodipine 5 mg/d)and therapy group(amlodipine 5 mg/d and cipramil 20 mg/d)for three months.The pretherapy and post-treatment changes in the two groups were compared between 24 h SBP,24 h DBP,dSBP,dDBP,nSBP,nDBP and scores of the short form(36)health survey.Results After treatment,24 h SBP[(128.74±3.79)mm Hg vs.(139.42±10.19)mm Hg],24 h DBP[(72.10±7.65)mm Hg vs.(78.64±8.03)mm Hg],dSBP[(130.81±4.50)mm Hg vs.(143.39±12.32)mm Hg],dDBP[(76.03±9.46)mm Hg vs.(81.53±9.20)mm Hg],nSBP[(126.94±3.69)mm Hg vs.(136.53±9.03)mm Hg],nDBP[(68.52±6.89)mm Hg vs.(75.44±7.57)mm Hg]were much lower in therapy group than the control group(all P<0.01).Besides physical functioning of quality of life,the other dimensions were much higher(role physical 70.84±9.90 vs.62.31±10.16,bodily pain 74.71±8.51 vs.63.33±8.48,general health 62.19±8.39 vs.50.64±7.07,vitality 64.03±8.26 vs.56.11±6.82,social function 70.94±6.94 vs.62.92±7.46,role-emotional 70.32±6.93 vs.62.14±8.18,mental health 69.94±6.44 vs.61.69±8.83,total score 68.70±3.29 vs.60.40±3.40,all P<0.01).Conclusions Besides antihypertensive therapy,antidepression therapy also should be put more attention in the elderly hypertensive people with depression.

关 键 词：高血压 抑郁 老年人 生命质量 

分 类 号：R544.1[医药卫生—心血管疾病]