抗抑郁焦虑治疗对老年舒张性心衰患者生活质量的影响

The effects of anti-anxiety and depression therapy on life quality of elderly patients with diastolic heart failure

目的观察抗焦虑抑郁治疗对老年舒张性心衰患者生活质量的影响。方法对老年舒张性心衰患者进行症状自评量表（SCL-90）测评阳性患者44例，随机分成两组，第1组21例，第2组23例；量表测评阴性的患者18例为第3组。3组患者均用慢性心功能衰竭指南治疗标准予以改善心脏舒张功能、利尿、活血化瘀及营养心肌常规治疗6m，第1组同时加用氢溴酸西酞普兰片。治疗前后进行SCL-90、明尼苏达心力衰竭生活质量问卷（the Minnesota living with heart failure questionnaire，MLHFQ）及心脏舒张功能指标E／A。结果（1）治疗后各组患者的MLHFQ除第2组以外均有好转，第1组MLHFQ治疗前（49．93±32．94），治疗后（25．94±26．85），P〈0．01差异有统计学意义；第3组治疗前MLHFQ（31．29±22．01），治疗后（19．19±18．24），P〈0．05差异有统计学意义。第1组MLHFQ（P〈0．01）好转更明显。（2）3组之间的SLC-90比较示抑郁、焦虑和总均分以第1组下降最显著。（3）第1组、第3组的心脏舒张功能提高，第2组无改变。结论抗焦虑抑郁治疗增加常规药物疗效，提高老年舒张性心衰患者的生活质量。

Objective To evaluate the effects of anti-anxiety and depression therapy on life quality of elderly patients with diastolic heart failure. Methods Elderly patients with diastolic heart failure were investigated with the Self report In-ventor Symptom Check-list 90 （SCL-90）. Forty-four patients with positive results in scale were divided into two groups randomly, group 1 （n=21） and group 2 （n=23）, and those with normal scores （n=18） were included to group 3. All patients were treated with regular treatment for six months, while those in group 1 had anti-anxiety and depression ther-apy at same time. Quality of life assessed with the Minnesota living with heart failure questionnaire （MLHFQ） and cardiac diastolic function measured by echocardiogram were compared Before and after medications,. Result （1） After the therapy, the MLHFQ scores were significantly improved in group land group 3 and with the greatest improvements in group 1. （2） The depression, anxiety factor scores and total average score were decreased mostly in group 1. （3） The had significant improvements in The diastolic heart functions were significantly improved in group 1 and group 3 after the therapy and with the greatest improvements in group 1 but not in group 2. Conclusion Anti- anxiety and depression therapy can enhance the effects of regular treatment and improve the quality of life in elderly patients with diastolic heart failure.