冠心病合并抑郁症的临床观察

The Clinical Analyze of Coronary Heart Disease with Depression

目的观察抑郁对冠心病的影响。方法选择我院2004年9月～2006年3月冠心病患者（均经冠脉造影确诊）63例，分为A组（冠心病不合并抑郁）、B组（冠心病合并抑郁＋未抗抑郁治疗）、C组（冠心病合并抑郁抗抑郁治疗）各21例。3组患者均常规应用治疗冠心病药物，C组在此基础上给予心理治疗及加服抗抑郁药盐酸氟西汀20mg／次，1次／d，顿服，共8周。观察治疗后3组患者心绞痛复发率、急性心肌梗死（AMI）及猝死发生情况、平板运动试验心肌缺血情况。结果3组患者心绞痛复发率、心肌缺血情况间差异均有显著性意义（P〈0．05），AMI及猝死情况因例数较少，未进行统计学处理。结论抑郁是影响冠心病预后的独立危险因素，抗抑郁治疗能明显改善冠心病伴抑郁患者的近期预后。

Objective To investigate the influence of depression to coronary heart disease. Methods Sixty - three coronary heart disease patients axe designed three groups： group A is coronary heart disease without depression （n = 21 ） ; group B is coronary heart disease with depression which don＇t received antidepression measures （ n = 21 ） ： group C is coronary heart disease with depression which received psychotherapy and antidepressant prozac 20mg qd for eight weeks （n = 21 ）. The three groups all received conventional cardiac medicinal therapy. In the base, the group C gave psychotherapy and antidepressant fluoxetine, 20mg one time, one time a day, 8 weeks. After treatrment, observed the relapse rate of angina, AMI, death rate, treadmill exercise test of myocardial ischemia. Results In the group A and group C myocardial ischemia were significantly improved and the recurrence rate of angina and incidence of AMI were lower. There were significant differences between A and B （ P 〈 0. 05）, so were B and C （ P 〈 0. 05）. Conclusion Depression is the independent dangerous factor to coronary heart disease and antidepression measures can significantly improve the short - term outcome of coronary heart disease patients.