米氮平联合常规抗心衰药物对慢性心力衰竭伴抑郁患者的疗效  

Efficacy of mirtazapine combined with conventional anti heart failure drugsonpatients with chronic heart failure and depression

作　　者：冯静[1] 张鹤凤 王岩[1] 王亦磊[1] 王彤[1] 

机构地区：[1]陕西省榆林市第一医院药剂科,榆林719000

出　　处：《国际精神病学杂志》2016年第3期458-460,473,共4页Journal Of International Psychiatry

摘　　要：目的探讨米氮平联合常规抗心衰药物治疗慢性心力衰竭伴抑郁患者的疗效。方法选取2014年1月至2015年4月我院收治的慢性心力衰竭合并抑郁的患者120例,随机分成试验组组及对照组,对照组患者采用慢性心力衰竭常规药物治疗,试验组患者采用慢性心力衰竭常规药物治疗联合米氮平15~30mg/d治疗。对比两组患者治疗前后的汉密尔顿抑郁量表评（HAMD）分及心功能。结果两组患者治疗前HAMD评分及新功能组间比较,差异无统计学意义（P〉0.05）。与治疗前相比,两组患者治疗后30d、90d、180d、300d HAMD评分均降低（P〈0.05）;与对照组相比,试验组治疗后30d、90d、180d、300d HAMD评分更低、评分差率更高,（P〈0.05）。与治疗前相比,两组患者治疗后左室射血分数及左室短轴缩短率均升高,6min步行试验距离延长,心率降低（P〈0.05）;与对照组相比,实验组上述心功能指标更优（P〈0.05）。结论米氮平联合常规抗心衰药物治疗慢性心力衰竭伴抑郁患者的疗效更佳,值得在临床中推广和应用。Objective To explore the efficacy of mirtazapine combined with conventional anti heart failure drugs on patients with chronic heart failure and depression. Method 120 cases of patients with chronic heart failure and depression in our hospital from January 2014 to April 2015 were selected andrandomly divided into experimental group and control group,60 cases for each. Patients in control group were treated by conventional anti heart failure drugs therapy for chronic heart failure while patients in experimentalgroupwere treated bymirtazapine combined with conventional anti heart failure drugs. The scores of Hamilton Depression Scale（HAMD）and cardiac function of patients in the two groups were evaluated and compared before and after treatments. Result There were no statistical difference of HAMD scores and cardiac functionbetween the two groups before treatments（P〉0.05）.30 d,90d,180 d and 300 d aftermedicine therapy,compared with before it,the scores of HAMD were much lower in the both two groups,all the differences had statistical significances（P〈0.05）.While compared with the control group,the scores of HAMD of the experimental group were lower and the score difference rate was bigger,all the differences had statistical significances（P〈0.05）. After medicine treatments,the The left ventricular ejection fraction and left ventricular shortening rate increased,6min walk test distance was prolonged andthe heart rate decreased in both of the two groups,and all the differences mentioned above had statistical significances（P〈0.05）;meanwhile,compared with the control group,the indexes of cardiac function of the experimentalgroup were much better（P〈0.05）. Conclusion The efficacy of mirtazapine combined with conventional anti heart failure drugs on patients with chronic heart failure and depression is more effective and it is worthy popularization and application in clinical work.

关 键 词：米氮平 慢性心力衰竭 抑郁 心功能 汉密尔顿抑郁量表 

分 类 号：R749.05[医药卫生—神经病学与精神病学]