心衰患者长期应用卡维地洛对心理状况的影响  

Long efficacy of the carvedilol on psychological state in the heart failure patients

作　　者：林钟文[1] 吴盛标[1] 黄志昕[1] 姜昕[1] 陈焕展[1] 陈科奇[1] 廖习清[1] 周其玲[1] 胡赤怡[2] 无 

机构地区：[1]暨南大学附属第二临床医学院,518000 [2]深圳市人民医院心内科,518000 [3]深圳市康宁医院心理科,518000

出　　处：《医药世界》2005年第12期53-54,共2页Medicine World

基　　金：深圳市科技局科研基金200204008赞助

摘　　要：目的了解心衰患者长期应用卡维地洛对患者心理状况的影响方法:100例慢性充血性心衰(CHF)患者,(男79例,女21例)平均53.23±16.42岁,心功能(NYHA分级)Ⅱ-Ⅳ级,抑郁者39例,焦虑者48例。卡维地洛从小剂量开始,逐渐递增,实验中严密检测各项相关指标。结果:随访98周,随访期间猝死1例,治疗后心功能有明显改善[(2.24±0.79)比(3.05±0.65)P<0.05],6分钟步行距离较治疗前亦有明显进步[(312.71±152.39)比(203.67±134.86)P<0.001],超声心动图示LVEF明显增加[(38.9±6.7)比(32.8±4.9)P<0.001],治疗后反映抑郁状态的SDS评分两组均稍有改善,但无统计学意义,显示焦虑状态的SAS评分均有明显改善,其中焦虑组(n=48)为[(41.57±11.73)比(67.48±16.37)P<0.001]非焦虑组(n=51)[(31.12±9.72)比(36.32±7.84)P<0.001].明尼苏达生活质量量表评分也有显著的改善[(23.86±9.64)比(41.63±13.76)P<0.05]。结论:卡维地洛长期治疗心衰患者除了能明显提高患者的活动耐量,改善心功能外,还能改善CHF患者的焦虑状况,但对抑郁状况无明显影响.Objective To know the long efficacy of the carvedilol on psychological state in the chronic heart failure （CHF） patients . Methods one hundred patients with CHF （male 79,female 21）,average age of 53.23 ± 16.42, heart function （NYHA） Ⅱ-Ⅳ, depression 39, anxiety 48. Underwent carvedilol therapy from small dose to the rule dose if they tolerated, the index of the trial were observed carefully. Results During 98 weeks follow-up, I patient died, after treatment NYHA classification was improved [（2.24 ± 0.79） vs （3,05 ± 0.65） p〈0.05], 6 minutes walk distance were improved markedly [（312.72 ± 152.39）m vs （203.67 ± 134.86）m p〈0,001], Left ventricular eject fraction [LVEF increased [（38.9 ± 6,7）% vs （32.8 ± 4.9）% p〈0.001], Self-Rating Depression Scale （SDS） shows the carvedilol therapy changes a little in depression, but it has no statistical difference. But the change for the anxiety is definite, in the group of anxiety （n=48） Self-Rating Anxiety Scale （SAS）[（41.57 ± 11.73） vs （67.48 ± 16.37） p〈0.001], in the group of no-anxiety （n==51）[（31.12 ± 9.72） vs （36.32 ± 7.84） p〈0.001], for the Minnesota Living with Heart Failure questionnaire the therapy shows effective [（23.86 ± 9.64） vs （41.63 ± 13.76） p〈0.05], Conclusion long efficacy of carvedilol on the heart failure patients could elevate their tolerents of activity and promote their heart function, beside that, it could change the anxiety state for the CHF, but it has not effecte on depression.

关 键 词：心力衰竭 卡维地洛 抑郁 焦虑 

分 类 号：R719.8[医药卫生—妇产科学] R541.6[医药卫生—临床医学]