对心脏早搏患者伴发的焦虑抑郁症状的治疗及其意义

The treatment and its significance in premature beats patients with anxiety and depression symptom

目的观察评价无器质性心脏病心脏早搏患者焦虑抑郁心理障碍情况,及对抗焦虑抑郁药物治疗的临床疗效。方法对有心悸等心血管病症状的房性、室性早搏患者,进行焦虑抑郁心理量表评分,选择有焦虑抑郁状态心脏早搏患者,随机分成抗焦虑抑郁药物治疗(5羟色胺再摄取抑制剂)组及安慰剂对照组,进行六周的双盲治疗研究,观察两组患者临床症状改善程度以及对心脏早搏的影响。结果共入选心脏早搏患者138例,汉密尔顿焦虑量表21.02±4.19分;汉密尔顿抑郁量表16.70±3.42分,均伴有较明显的焦虑抑郁状态。117例完成试验。治疗组(n=60)和安慰剂组(n=57)治疗均能有效缓解患者临床症状(P<0.05),但治疗组较安慰剂组疗效更明显?P<0.05)。治疗前后室性早搏变化不明显?P>0.05),但房性早搏明显减少(P<0.05)。结论有持续心血管病症状的心脏早搏患者常伴有焦虑抑郁心理障碍,应用抗焦虑抑郁药物治疗,能有效缓解患者的临床症状,同时,减少房性早搏的发生。

Objective To observe and assess the psychological disorders such as anxiety and depression in arrhythmic patients without organic heart disease as well as clinical efficacy of pharmacotherapy using an antidepressants. Methods The patients with atrial premature beats or ventricular premature beats who often had the symptom of palpitation were rated with HAMA （Hamilton anxiety Scale） and HAMD （Hamilton depression Scale）. Subjects having premature beats and meeting the criteria of anxiety and depression in Scales were randomly assigned to the two groups ： drug-treatment by antide- pressants and placebo alone. Results One hundred and thirty-eight patients with premature beats were enrolled. The mean scores of HAMA and HAMD were 21.04 ± 4.19 and 16.70 ± 3.42, respectively, which denoted that all of the selective patients were in an obvious condition of anxiety or depression. 117 cases completed tests. Clinical symptom was relieved effectively both in drug-treatment group（n =60） and placebo group（n =57） （ P 〈0.05）. But the efficacy of the former showed significantly greater than the latter＇ s （ P 〈 0.05 ）. There was no difference of ventricular premature beats between before care and after care （ P 〉 0.05 ）. However atrial premature beats was apparently decreased after care （ P 〈 0.05 ）. Conclusion The patients with premature beats who suffered sustained cardiovascular symptom are often accompanied by psychological disorders of anxiety and depression. The clinical symptom and incidence of atrial premature beats of these individuals could be alleviated by taking antidepressants.