氟哌噻吨美利曲辛片对高血压合并焦虑抑郁患者血压变异性及动态动脉硬化指数的影响  

Effects of Flupentixol and Melitracen Tablets on blood pressure variability and ambulatory arterial stiffness index in hypertensive patients with anxiety and depression

作　　者：李杰[1] 朱林德 LI Jie;ZHU Linde(Department of Cardiology t the First Affiliated Hospital of Nanyang Medical College y Henan 413058,China)

机构地区：[1]河南省南阳医学高等专科学校第一附属医院心血管内科,473058 [2]河南省南阳市第四人民医院,473000

出　　处：《安徽医学》2018年第8期960-965,共6页Anhui Medical Journal

摘　　要：目的探讨氟哌噻吨美利曲辛片对高血压合并焦虑抑郁患者血压变异性及动态动脉硬化指数的影响。方法选取2014年9月至2016年10月南阳医专第一附属医院门诊或住院收治的原发性高血压且汉密尔顿焦虑量表(HAMA)评分≥14分和/或汉密尔顿抑郁量表(HAMD)评分≥20分的患者126例为研究对象,经降压药物治疗并行动态血压检测血压达标后(24 h动态血压<130/80 mm Hg),按随机数字表法分为观察组和对照组,每组各63例。观察组在降压药物基础上加用氟哌噻吨美利曲辛片,并辅助心理疏导;对照组在降压药物基础上单纯辅助心理疏导。治疗24周后比较两组患者治疗前、后动态血压、血压变异性(BPV)[包括24小时平均收缩压(24 h m SBP)、24小时平均舒张压(24 h m DBP)、24小时收缩压标准差(24 h SSD)、24小时舒张压标准差(24 h DSD)、白天收缩压标准差(d SSD)、白天舒张压标准差(d DSD)、夜间收缩压标准差(n SSD)、夜间舒张压标准差],动态动脉硬化指数(AASI)、HAMA评分、HAMD评分。采用pearson相关性分析HAMA评分HAMD评分与AASI的相关性。结果治疗前两组患者HAMA评分、HAMD评分与AASI呈正相关(r=0.477,0.552,P均<0.05);治疗后观察组BPV较治疗前下降,治疗后观察组BPV低于对照组,差异均有统计学意义(P<0.05);治疗后观察组AASI较治疗前下降,治疗后观察组AASI低于对照组,差异均有统计学意义(P<0.05);治疗后两组患者HAMA评分及HAMD评分均较治疗前下降,且治疗后观察组低于对照组,差异均具有统计学意义(P<0.05)。结论氟哌噻吨美利曲辛片不仅可改善高血压合并焦虑抑郁患者症状,还能降低BPV及AASI。Objective To investigate the effects of Flupentixol and Melitracen Tablets on blood pressure variability and ambulatory arterial stiffness index in hypertensive patients with anxiety and depression. Methods A total of 126 hypertensive patients with anxiety and depression in this hospital from Sept 2014 to Oct 2016 were divided into observation group and control group with 63 cases in each group after blood pressure standards. The observation group was given Flupentixol and Melitracen Tablets and psychological counseling on the basis of conventional antihypertensive drugs, while the control was given psychological counseling only on the basis of conventional antihypertensive drugs, and they were under observation for 24 weeks. Ambulatory blood pressure, blood pressure variability, ambulatory arterial stiffness in-dex, HAMA score, HAMD score and adverse reactions were compared between groups. Results HAMA score and HAMD score were posi-tively correlated with AASI. After treatment, the blood pressure variability of observation group was significantly lower than that before treat-ment and control group, and the difference was statistically significant ; After treatment, the ambulatory arterial stiffness index of observation group was significantly lower than that before treatment and control group, and the difference was statistically significant. After treatment, the HAMA score and HAMD score of observation group and control group were lower than those before treatment, but the observation group de-creased lower, and the difference was statistically significant. Adverse reactions in observation group were mild. Conclusion Flupentixol and Melitracen Tablets can not only improve the symptoms of hypertensive patients with anxiety and depression, but also decrease blood pres-sure variability and ambulatory eirterial stiffness index.

关 键 词：高血压 焦虑抑郁 血压变异性 动态动脉硬化指数 

分 类 号：R544.1[医药卫生—心血管疾病] R749[医药卫生—内科学]