阿米替林、美舒郁对血流动力学影响的脉图检测研究

The Sphygmogam Study of Hemodynamics Influenced by Amitriptyline Contrasted with Trazodone.

目的 观察研究阿米替林、美舒郁造成的血流动力学改变 ,对比 2药对心血管功能的不同影响。方法 把符合条件的 2 0 8例抑郁症患者 ,随机分成两组 ,一组用阿米替林治疗 ,一组用美舒郁治疗 ,并在用药前及用药后 1周末、2周末、4周末用血液循环动力学脉图检测仪检测病人的血流动力学参数 ,观察项目 :HR、ECV、MEC、LME、MIT、MVO。结果 阿米替林组 1周末即有 MIT改变。自 2周末各个参数均出现明显差异 (P<0 .0 5 ) ,到 4周末 ECV、LME、MVO的改变尤为明显(P<0 .0 0 1 )。而美舒郁组只有 LME 4周末有明显降低 (P<0 .0 5 )。结论 美舒郁抗抑郁治疗时对心脏的影响较小 ,而阿米替林对心脏有明显的影响 ,表现为心率加快 ,有效循环血容量降低 ,心肌耗氧量明显增加 ,心肌供血障碍 ,左室效能降低 ,同时 ,用药时间越长 ,剂量越大 。

Objective To explore the effect of Amitriptyline and Trazodone to the hemodynamics and contrast their effects.Methods To divide 208 cases of depressive patients up to the standards into two groups randomly,one group therapied by Amitriptyline,another by Trazodone,then test the patients's hemodynamics parameters with Circulation dynamics(CD)at the end of the first weekend,the second weekend and the fourth weekend.Observation program the parameters of HR,ECV,MEC,LME,MIT,MVO.Result LME of Trazodone group was significantly declined after four weeks of therapy(P<0.05),in the Amitriptyline group,MIT had changed after the first week,other parameters had no significant diffrence(P>.05).All parameters presented significant difference(P<0.05)after two weeks,ECV,LME,MVO,presented more significant difference(P<0.01)after four weeks.Conclusion Trazodone has a minor effect on cardiovascular system,while Amitriptyline has a significant effect presenting accelerating of heart rate,reducing of effective circulation volume,increasing of consumed oxygen of cardiac muscle,obstructing of cardiac blood-supply,declining of left ventricle function.Moreover,the longer the time,the larger the dose,the more significant effect the medicine has on the heart.