黛力新对冠心病心衰合并抑郁病人血清脂联素和血浆BNP浓度的影响  

Effects of Flupentixol and Melitracen on the Concentrations of Serum Adiponectin and Plasma BNP in Patients with Coronary Heart Disease-related Heart Failure Complicated with Depression

作　　者：张敏莉[1] 孙静[1] 朱铭[1] 魏洪杰[1] 石俊婷[1] 金鹏[1] 

机构地区：[1]中国石油天然气集团公司中心医院,河北廊坊065000

出　　处：《中西医结合心脑血管病杂志》2017年第1期66-69,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的观察抗抑郁治疗6个月对合并抑郁综合征的冠心病心衰病人血清脂联素(APN)和血浆B型钠尿肽(BNP)浓度的影响。方法对62例确诊为冠心病心衰(心功能NYHAⅢ级~Ⅳ级)且合并有抑郁综合征的病人,随机分为对照组和治疗组,每组31例,对照组采用冠心病和心衰的常规治疗方案及心理干预,治疗组在对照组治疗基础上加用黛力新片(氟哌噻吨美利曲辛)治疗。两组均治疗6个月,比较两组汉密尔顿抑郁量表(HAMD)评分(24项)、6min步行试验、左室舒张末内径(LVEDD)、左室射血分数(LVEF)及血清APN和血浆BNP浓度。结果与对照组相比,治疗组出院6个月后HAMD评分明显改善[(25.84±5.88)分vs(19.98±6.29)分,P<0.05],6min步行试验距离明显提高[(264.7±31.4)m vs(331.4±32.4)m,P<0.05],LVEF值明显升高[(33.03±6.34)%vs(36.87±6.98)%,P<0.05],血清APN浓度明显升高[(89.66±21.37)ng/mL vs(102.78±23.18)ng/mL,P<0.05],血浆BNP浓度明显降低[(467±93)pg/mL vs(312±83)pg/mL,P<0.05],两组间LVEDD比较差异无统计学意义。结论对合并抑郁综合征的冠心病心衰病人给予抗抑郁治疗6个月可显著缓解病人抑郁症状,改善心功能,使血清APN浓度升高、血浆BNP浓度降低。Objective To investigate the effects of flupentixol and melitracen（deanxit）on serum adiponectin（APN）and plasma Btype natriuretic peptide（BNP）in patients with coronary heart disease（CHD）-related heart failure（HF）complicated with depression.Methods Sixty-two patients with CHD-related HF complicated with depression were randomly divided into two groups：control group（n =31）treated with routine treatment and psychological intervention,and treatment group（n =31）treated with flupentixol and melitracen in the basis of routine treatment and psychological intervention for 6 months.Hamilton Depression Rating Scale（HAMD）scores,6-minute walk test（6 mWT）,the values of left ventricular end diastolic diameter（LVEDD）and left ventricular ejection（LVEF）,the levels of serum APN and plasma BNP were compared between two groups.Results Compared with the control group,HAMD scores was significantly improved in treatment group[（25.84±5.88）vs（19.98±6.29）,P〈0.05].6 mWT was significantly increased[（264.7±31.4）m vs（331.4±32.4）m,P〈0.05 ].The value of LVEF was significantly enhanced in treatment group[（33.03±6.34）% vs（36.87±6.98）%,P〈0.05 ].The level of serum APN was significantly increased in treatment group[（89.66±21.37）ng/mL vs（102.78±23.18）ng/mL,P〈0.05].The level of plasma BNP was significantly decreased in treatment group[（467±93）pg/mL vs（312±83）pg/mL,P〈0.05].There was no significant difference in the value of LVEDD between two groups.Conclusion Antidepressant treatment for 6 months can relieve the symptom of depression,improve the heart function,increase the level of serum APN and decrease the level of plasma BNP in patients with CHD-related HF complicated with depression.

关 键 词：冠心病 心衰 抑郁 脂联素 B型钠尿肽 黛力新 

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