舍曲林联合心理治疗对合并焦虑、抑郁情绪的急性心肌梗死患者的情绪和心功能的影响

The Effect of sertraline combined psychotherapy on acute myocardial infarction patients with anxiety and depression and its influence to heart function

目的分析合并抑郁、焦虑情绪的急性心肌梗死患者应用舍曲林治疗后的效果及心功能指标水平的变化。方法选取我院于2018年6月~2019年6月收治的89例合并抑郁、焦虑的急性心肌梗死患者,依据患者入院先后顺序分为对照组患者44例及观察组患者45例,两组患者均给予心肌梗死常规治疗,对照组患者增加心理治疗,观察组患者在对照组基础上增加舍曲林口服治疗,对比两组患者治疗后心输出量(CO)、左室射血分数(LVEF)、心搏量(SV)、汉密尔顿抑郁量表评分(HAMD)、汉密尔顿焦虑量表评分(HAMA)、血清内皮素-1(ET-1)、超敏-C反应蛋白(hs-CRP)、人纤溶酶原激活物抑制因子-1(PA-1)、血管紧张素Ⅱ(AngⅡ)水平变化。结果治疗前,两组患者各项指标没有明显差异。治疗后,观察组hs-CRP、AngⅡ、ET-1、PA-1水平及HAMD、HAMA评分均低于对照组,SV、CO及LVEF水平均高于对照组(P<0.05)。结论舍曲林联合心理治疗能够有效消除急性心肌梗死合并情绪障碍患者的负面情绪,改善心功能。

Objective To analyze the Effect of sertraline combined psychotherapy on acute myocardial infarction patients with anxiety and depression and its influence to heart function.Methods Eighty-nine acute myocardial infarction patients with anxiety and depression who were treated in our hospital from June 2018 to June 2019 were selected and divided into 44 patients in the control group and 45 patients in the observation group according to the order of admission.All the patients recieved conventional treatment of myocardial infarction.Patients in the control group increased psychological therapy.Patients in the observation group added sertraline orally on the base of the control group.The cardiac output(CO),left ventricular ejection fraction(LVEF),and heart were compared.Stroke Volume(SV),Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale Rating(HAMA),Serum Endothelin-1(ET-1),Hypersensitivity-C Reactive Protein(hs-CRP),Human Fibrinolysis Changes of zymogen activator inhibitor factor-1(PA-1)and angiotensinⅡ(AngⅡ)levels were compared between two groups before an after treatment.Results After treatment,the levels of hs-CRP,AngⅡ,ET-1,PA-1 and HAMD and HAMA scores in the observation group were lower than those in the control group,and the levels of SV,CO and LVEF were higher than those in the control group(P<0.05).Conclusion Sertraline combined with psychotherapy can effectively eliminate the negative emotions of acute myocardial infarction patients with anxiety and depression,promote cardiac function recovery.