慢性充血性心力衰竭合并抑郁障碍患者的临床研究  

Depressive disorder in hospitalized patients with congestive heart failure

作　　者：刘向群[1] 谭洪勇[1] 郜宪林[2] 张铭朋[1] 刘金忠[2] 

机构地区：[1]山东大学齐鲁医院干部保健科,山东济南250012 [2]山东省菏泽医学专科学校生理学教研室,山东菏泽274030

出　　处：《山东大学学报（医学版）》2005年第4期294-296,300,共4页Journal of Shandong University:Health Sciences

基　　金：山东省科技厅资助课题(2002)

摘　　要：目的:探讨抑郁障碍在慢性充血性心力衰竭(CHF)患者中的患病率及对预后的影响,观察抗抑郁药物盐酸氟西汀(商品名百忧解)对CHF患者的作用。方法:按照Zung抑郁自评量表评分,以≥50分和<50分为标准将患者分为抑郁障碍组和无抑郁障碍组;再将抑郁障碍组患者随机分为百忧解组和安慰剂组,同时选择健康查体者30人作为对照组,比较CHF组与对照组抑郁评分的差别;出院时对CHF患者重新评分,比较各组抑郁评分的变化,观察百忧解的不良反应;3个月时随访入组的CHF患者,分析各组CHF患者死亡率、再入院率的差异。结果:CHF组抑郁障碍的发生率高于对照组(P<0.01);抑郁障碍组患者的住院时间长于无抑郁障碍组(P<0.01);出院时百忧解组评分比安慰剂组显著降低(P<0.01);安慰剂组患者3个月的死亡率、再入院率高于无抑郁障碍组(P<0.001)及百忧解组(P<0.05);百忧解组患者在服药期间无不良反应。结论:抑郁障碍在心力衰竭患者中的患病率高达35.8%,是心衰患者预后不良的重要危险因子;百忧解治疗心力衰竭患者的抑郁症状疗效好,安全性高。Objective: To investigate the influence of depressive disorder in prognosis of patients with congestive heart failure (CHF) and observe the safety and effectiveness of fluoxetine on these patients. Methods: Two hundred and twelve hospitalized patients with CHF were scored by Zung self-rating depression scale. Those scored 50 or higher belonged to depressive disorder group, while those below 50 belonged to no depressive disorder group. The former was subdivided into fluoxetine and placebo group. At the same time, 30 healthy were picked as matched control. All the patients were reexamined when discharged from hospital, analysed the variation of scores and observed the adverse effect of fluoxetine; three months later, they were compared the mortality rate and rehospitalization rate. Results: The incidence rate of depressive disorder was higher in CHF than that in healthy control and the stay of depressive disorder patient was longer than that of none. The post-treatment score of fluoxetine group was lower than that of pretreatment and also strikingly lower than that of placebo. The mortality rate and rehospitalization rate of placebo group were much higher than those of no depression group and fluoxetine group. There was no ill effect of fluoxetine. Conclusion: The prevalence rate of depression in patients with CHF is high. Depression increases the stay, mortality and rehospitalization rate of patients. Flouxetine is safe and effect in the treatment of depression.

关 键 词：心力衰竭 充血性 抑郁障碍 药物疗法 

分 类 号：R541.6[医药卫生—心血管疾病]