抗抑郁治疗对老年高血压合并抑郁障碍患者血压的影响  

Effect of antidepressant therapy on blood pressure in elderly hypertensive patients with depression

作　　者：李海聪[1] 李求兵[1] 杨毅玲[2] 朱赫[1] 王燕[1] 田心[1] 陈晓光[1] 李渊 杨学青[1] 

机构地区：[1]中日友好医院老年医学科,北京100029 [2]北京中医药大学诊断教研室 [3]University of Maryland College Park

出　　处：《中华老年心脑血管病杂志》2016年第2期143-148,共6页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：中日友好医院院级科研基金资助项目(2010-MS-37)

摘　　要：目的研究抗抑郁治疗对老年高血压合并抑郁障碍患者血压的影响及其改善生活质量的临床疗效。方法老年高血压合并抑郁障碍患者304例,随机分为治疗组156例和对照组148例,分别给予盐酸曲唑酮和盐酸曲唑酮模拟药,2组治疗4周,观察治疗前和治疗后第1、2、3、4周患者血压、17项汉密尔顿抑郁量表(HAMD17)、汉密尔顿焦虑量表(HAMA)、健康状况问卷(SF-36)和治疗药物副作用量表等评分的变化,判断2组的临床疗效。结果治疗组第3、4周末HAMD17评分较对照组显著降低,治疗组抑郁治疗的有效率优于对照组(79.9%vs 28.3%,P<0.05);治疗组的目标血压达标率显著高于对照组(76.4%vs 44.9%,P<0.01)。治疗组HAMA评分第3、4周末较对照组显著下降(P<0.01);2组SF-36总分及各项评分治疗第4周末较治疗前均有显著提高(P<0.05,P<0.01),治疗组生理功能、躯体疼痛、生命活力、社会功能和健康变化等的改善优于对照组(P<0.05)。结论抗抑郁治疗有助于改善老年高血压合并抑郁障碍患者的血压和生存质量。Objective To study the effect of antidepressant therapy on blood pressure in elderly hypertensive patients with depression.Methods Three hundred and four elderly hypertensive patients with depression were randomly divided into treatment group（n=156）and control group（n=148）.The patients in two groups were treated with trazodone and its simulator,respectively,for 4 weeks.Their blood pressure,HAMD17 score,HAMA score,SF-36 score and treatment emergent symptom scale score were recorded before and after treatment in order to observe the clinical effect of antidepressant therapy in two groups.Results The HAMD17 score was significantly lower,the effect of antidepressant therapy and the rate of normal blood pressure were significantly higher in treatment group than in control group at the end of 3and 4weeks after treatment（79.9%vs 28.3%,P〈0.05;76.4%vs 44.9%,P〈0.01）.The total SF-36 score and other scores were significantly higher in two groups after treatment than before treatment（P〈0.05,P〈0.01）.The physiological function,somatalgia,vital activity,social function and health improved much better in treatment group than in control group after treatment（P〈0.05,P〈0.01）.Conclusion Antidepressant therapy can improve the blood pressure and quality of life in elderly hypertensive patients with depression.

关 键 词：抑郁症 高血压 曲唑酮 血压 生活质量 抗抑郁药 

分 类 号：R544.1[医药卫生—心血管疾病]