双心(心脏心理)疾病在综合医院筛查与诊疗流程模式探索

The Exploration of Screening and Diagnosis and Treatment Process Model of Pchycardiological Disease in General Hospital

大量的证据表明包括抑郁和焦虑在内的精神心理问题对人的心脏有不良影响。双心医学的流行病学显示,抑郁好发于心血管疾病患者并使心血管疾病预后恶化。在中国的双心疾病识别率和治疗率较低,研究显示,急性心肌梗死后抑郁的及时诊断率不到10%。目前非常迫切地需要改变我国双心疾病低识别低治疗的现状,建议应从筛查入手,建立规范的双心疾病诊疗流程。心脏科医师应将抑郁因素纳入日常的冠心病诊疗流程中,无论是需要治疗与否或转诊与否。抗抑郁治疗包括药物认知和行为治疗。抗抑郁药物5-羟色胺再摄取抑制剂中舍曲林对于冠心病患者安全有效,可用于治疗轻中重度抑郁症。

More studies have examined the link between established indices of psychologic disorder including depression anxiety and prognosis in individuals with known heart disease. Depression is commonly present in patients with coronary heart disease （CHD） and is independently associated with increased cardiovascular morbidity and mortality. In China, Pchycardiological disease recognition rate and therapy is low, research shows that acute myocardial infarction depression timely diagnosis rate less than 10%. This is a pressing need to change our country Pchycardiological disease low recognition low treatment status, the proposal should be of screening, and set up standard Pchycardiological disease diagnosis and treatment process. A cardiologist should take depression factors into the daily coronary heart disease diagnosis and treatment process, whether need treatment or not or referral or not. Antidepressant treatment includes drug cognitive and behavioral therapy. Among antidepressant drugs, selective serotonin reuptake inhibitor （SSRI） such as Sertraline in depressive patients with coronary artery disease may be safe and effective. and can be used in the treatment of mild-to-moderate depression.