心理干预对急性冠状动脉综合征伴抑郁患者心功能的影响

Effects of mental intervention for depression on cardiac function in patients with acute coronary artery syndrome

目的 探讨心理干预对急性冠状动脉综合征（ACAS）患者抑郁情绪及心脏功能的影响。方法 应用抑郁自评量表（SDS）评价168例ACAS患者，其中102例井发抑郁的ACAS患者随机分成心理干预组52例与对熙组50例，对照组给予常规心血管药物治疗，干预组则在常规心血管药物治疗的基础上进行综合心理干预，抑郁情绪严重者服用适量抗抑郁药物治疗，疗程1个月；治疗前后应用抑郁自评量表（SDS）及汉密顿抑郁量表（HRSD）进行评估，并应用超声心动图对患者的左心室射血分数（LVEF）进行评价。结果 本组ACAS患者抑郁发生率为60，7％。1个月后，心理干预组SDS厦HRSD评分显著低于对熙组[（21．79±5．58）vs（36．95±6．96）；（9．89±4．42）VS（18．04±6．54），P〈0．05～0．01]，LVEF显著高于对照组[（55，6±6．1）％vs（47．2±4．3）％，P〈0．05]。结论在心血管药物治疗的基础上，心理干预能有效消除ACAS惠者的抑郁情绪，改善心脏功能。

Objective To explore the effects of mental intervention for depression on cardiac function in patients with acute coronary artery syndrome（ACAS）. Methods One hundred and sixty-eight patients were assessed with Selfrating Depression Scale and Depression Inventory（SDS）, 102 ACAS patients with depression were divided into control group and mental intervention group randomly, then treated with routine cardiovascular medicine singly or combined with mental intervention for one month. SDS and Hamilton Depression Rating Scale for Depression （HRSD） were assessed to observe the curative effects,and left ventricular ejection fraction（LVEF） was examined by echocardiography before and after the treatment. Results The attack rate of depression in the patients with ACAS was 60.7%. After one month treatment, the scores of SDS and H RSD were lower significantly [（21.79 ± 5.58） vs （36.95 ±6. 96） ; （9.89 ± 4.42） vs （18. 04±6.54）, P〈0.05-0.01] and LVEF was significantly higher [（55.6±6.1）% vs （47.2±4. 3）%, P 〈0.05] in mental intervention group than those in control group. Conclusion Mental intervention combined routine cardiovascular medicine had better effects on depression and cardiac function in patients with ACAS.