老年冠心病伴抑郁症的疗效观察

To investigate prognosis of elderly coronary heart disease patients with depression

目的探讨老年冠心病伴抑郁症的临床特点及进行抗抑郁药和社会心理干预治疗的疗效。方法将235例老年冠心病伴抑郁症的患者进行心理评估，随机分为对照组、抗抑郁药物治疗组。对照组给予单纯常规心脏病药物治疗，抗抑郁药物治疗组在常规心脏病药物治疗基础上给予冠心病健康教育、抗抑郁药。对两组患者的临床特点、家庭及社会支持、心血管事件的发生率等进行对比分析并随访。结果治疗组心肌缺血明显改善，心绞痛复发率及急性心肌梗死发生比率与对照组比较，差异有统计学意义（P〈0．05）。结论心理评估基础上的冠心病健康教育与抗抑郁药物治疗能改善冠心病伴抑郁患者的症状及预后。

Objective To investigate clinical features and the influence of health education and anti-depressive therapy on prognosis in elderly coronary heart disease patients with depression. Methods 235 patients were randomly assigned to anti-depressive medical treatment group and control group. Patients receive health education and anti-depressant on the basis of conventional cardiac medicinal therapy;while patient in the control group received only conventional cardiac medicinal therapy. Clinical features ,family conditions, society factors, incidence of cardiovascular events of two groups were analyzed. Results In the anti-depressive medical treatment groups,myocardia lischemia was mote significantly improved and the recurrence rate of angina and in-cidence of AMI were lower. There were significant differences compared with the control group（P〈0.05）.Conclusion Health education and anti-depression measures can significantly improve the outcome of elderly coro-nary heart disease patients.