艾司西酞普兰治疗老年冠心病介入术后抑郁症状的效果及对血浆5-HT、BDNF、NE水平的影响  

Effects of escitalopram on the depressive symptoms and plasma levels of 5-HT,BDNF,NE in elderly patients with coronary heart disease after percutaneous coronary intervention

作　　者：李刚 刘晓东[2] LI Gang;LIU Xiaodong(Department of Public Health,Anding Hospital,Inner Mongolia,Chifeng 024000,China;不详)

机构地区：[1]内蒙古自治区赤峰市安定医院公共卫生科,024000 [2]内蒙古自治区赤峰市医院器官移植外科

出　　处：《河北医药》2022年第18期2790-2793,共4页Hebei Medical Journal

摘　　要：目的研究艾司西酞普兰治疗老年冠心病介入术后抑郁症状的效果,为介入术后抑郁症临床治疗提供参考。方法选取接受经皮冠状动脉介入(PCI)术的86例老年冠心病患者,随机分为对照组和治疗组,每组43例,在规范化冠心病治疗基础上,对照组予以心理干预,治疗组在对照组基础上加用艾司西酞普兰,观察2组抑郁症状疗效、心血管事件发生率及外周血5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、去甲肾上腺素(NE)水平变化。结果治疗组治疗后4、8周HAMD评分均较治疗前下降(F_(时点间)=4.928,P_(时点间)=0.029);2组HAMD评分在组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05);治疗8周后抑郁症状疗效显示,治疗组总有效率显著高于对照组(P<0.01);与治疗前比较,治疗8周后治疗组血浆5-HT、BDNF、NE均升高(P<0.05);且治疗后治疗组血浆5-HT、BDNF、NE水平均明显高于对照组(P<0.05)。治疗组术后1年主要出现再发心绞痛、非致死性心肌梗死、严重心律失常等心血管事件总发生率较对照组显著降低,差异有统计学意义(P<0.05)。结论艾司西酞普兰可显著改善老年冠心病患者介入术后抑郁症状,并能降低其术后心血管事件发生率,改善其预后,值得临床推广。Objective To investigate the effects of escitalopram on the depressive symptoms and plasma levels of 5-HT,BDNF,NE in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI),so as to provide reference for the clinical treatment of depression after intervention.Methods A total of 86 elderly patients with CHD who were treated by PCI in our hospital were enrolled in the study,who were randomly divided into two groups,with 43 cases in each group.On the basis of standardized coronary heart disease treatment,the patients in control group were given psychological intervention,however,those in observation group,on the basis of control group,were given escitalopram.After treatment,the clinical efficacy,and the changes of depressive symptoms,the incidence of cardiovascular events,and the levels of peripheral blood 5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),and norepinephrine(NE)levels were observed and compared between the two groups.Results At 4w and 8w after treatment,the HAMD scores in observation group were significantly decreased(P<0.05),there were significant differences in the HAMD scores in different time points and interaction between the two groups(P<0.05).Moreover the total effective rate(93.02%)in observation group was significantly higher than that(67.44%)in control group(P<0.01).As compared with those before treatment,the serum levels of 5-HT in observation group after 8-week treatment were significantly inecreased(P<0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05).In addition the incidence rates of of recurrent angina pectoris,non-fatal myocardial infarction,severe arrhythmia and other cardiovascular diseases at 1 year after treatment in observation group were significantly lower than those in control group(P<0.05).Conclusion The escitalopram can obviously improve the postoperative depressive symptoms of patients with CHD,and decrease the incidence of postoperative cardiovascular events and imp

关 键 词：艾司西酞普兰 冠心病 经皮冠状动脉介入 抑郁症状 

分 类 号：R971.43[医药卫生—药品]