抗抑郁治疗对伴抑郁症状的慢性心力衰竭患者心功能及近期预后的影响  

Influence of anti-depression therapy on cardiac function and short-term prognosis in elderly patients with congestive heart failure

作　　者：刘向群[1] 谭洪勇[2] 单培彦[3,4] 郜宪林[5] 张铭朋[1] 刘金忠[5] 

机构地区：[1]山东大学齐鲁医院干部保健科,济南市250012 [2]山东省济宁医学院临床学院 [3]山东大学齐鲁医院,济南市250012 [4]神经内科 [5]山东省菏泽医学专科学校

出　　处：《中华老年医学杂志》2006年第5期339-342,共4页Chinese Journal of Geriatrics

基　　金：山东省科技厅立项课题[A200215（4）]

摘　　要：目的观察抗抑郁治疗对合并抑郁症状的老年慢性充血性心力衰竭(心衰)患者治疗前后心功能及近期预后的影响以及应用氟西汀的安全性和有效性。方法将伴抑郁症状的96例心衰患者随机分为2组,分别在常规抗心衰治疗的基础上加用氟西汀及安慰剂治疗3个月,分析2组患者治疗前后 Zung 抑郁自评量表(SDS)评分的抑郁指数、心功能、6个月内再入院率及6个月时存活率的差异。结果老年心衰患者抑郁障碍的患病率为31.1%;治疗3个月后,氟西汀组 SDS 评分抑郁指数(51.39%±8.63%)、6个月内再入院率(53.8%)低于安慰剂组(P<0.01,P<0.05);左心室射血分数(53.4%±4.5%)显著高于安慰剂组(P<0.05);而且服药期间不良反应极低。结论抗抑郁治疗可以改善合并抑郁障碍的老年心衰患者的心功能及近期预后;氟西汀可改善老年心衰患者的抑郁症状,且疗效好、安全性高。Objective To investigate the influence of anti-depression therapy on cardiac function and short-term prognosis in elderly patients with congestive heart failure （CHF） and the safety and effectiveness of fluoxetine in these patients. Methods Ninety six elderly hospitalized patients with CHF accompanied with depressive disorder were randomly divided into two groups： fluoxetine （20 mg once daily） and placebo treated groups based on the routine cardiac drug therapy for 3 months. Results The prevalence rate of depressive disorder in elderly patients with CHF was 31.1%. The length of stay of fluoxetine group was shorter than that of placebo group. The post-treatment depressive exponents of self-rating depression scale（SDS）in fluoxetine group （51.39 % ±8.63 %）was lower than those in pretreatment and in placebo group. The improvement of cardiac function in fluoxetine group （53.4% ±4.5%） was much better than that of placebo group （P 〈 0.05） . Furthermore, the re-admission rate （53.8% ± 4.5 %）of fluoxetine group at the end of the follow-up period was much lower than that of placebo group（P〈0. 01）. There were few adverse effects found in fluoxetine group. Conclusions The prevalence rate of depressive disorder in elderly patients with CHF is high. Anti-depression therapy of fluoxetine can improve cardiac function and short-term prognosis of elderly depressive patients with CHF. Flouxetine is safe and effective for those patients.

关 键 词：心力衰竭 充血性 抑郁 氟西汀 

分 类 号：R541.6[医药卫生—心血管疾病] R749.4[医药卫生—内科学]