抗抑郁治疗对合并抑郁的不稳定型心绞痛患者血浆脂联素水平的影响

Effects of Antidepressant Treatment on the Level of Adiponectin in Patients with Uunstable Angina Pectoris and Depression after Percutaneous Coronary Interventions

目的观察抗抑郁治疗对合并抑郁综合征的不稳定型心绞痛患者经皮冠状动脉介入治疗（PCI）术后6个月血清脂联素水平的影响。方法将117例确诊为冠心病不稳定型心绞痛并行PCI术治疗且合并有抑郁综合征的患者，随机分为两组：对照组（55例）和治疗组（62例），对照组采用正规冠心病二级预防治疗方案及心理干预，治疗组在对照组治疗基础上加用黛力新（氟哌噻吨美利曲辛）治疗；两组均治疗6个月，比较两组患者血清脂联素浓度、汉密尔顿抑郁量表（HAMD）评分（24项）、心绞痛发作、血脂等指标。结果与对照组相比，治疗组6个月后脂联素浓度明显升高[（105．59±30．09）ng/mLvs．（93．48±32．66）ng／mL，P〈0．05），HAMD评分均有明显改善[17．65±6．46vs．23．13±5．83，P〈0．05]，治疗组较对照组心绞痛发作例数较少（3例VS．14例，P〈0．05），两组问血脂无明显差异。结论对合并抑郁综合征的不稳定型心绞痛患者在PCI术后进行抗抑郁治疗6个月可显著提高血清脂联素浓度，缓解患者抑郁症状，减少心绞痛发作。

Objective To investigate the effects of antidepressant treatment on the level of adiponectin （APN） in patients with unstable angina pectoris （UA） and depression six months after pereutaneous coronary interventions （PCI）. Methods A total of 117 patients with UA and depression after PCI were randomly divided into two groups： （55 cases in a control group （n=55） and 62 cases in a treatmenttherapy group （n=62）. These patients were all taken the secondary preventative regimen of normal coronary heart disease （CHD） secondary prevention treatment and psychological intervention, while and the treatmenttherapy group was additionally treated with deanxit （ Flupentixol and Melitracen）. After All lasted for 6 months of treatment, both groups were compared for the levels of serum APN and lipids, and the onset of angina pectoris. They were scored using the Hamilton depression rating scale （HAMD）, angina pectoris symptom, and serum lipids were compared between two groups. Results In therapy group, Compared with the control, the treatment group produced a remarkably increased the level of APN was significantly increased [（105.59±30.09） ng/ ml vs. （93.48±32.66） ng/ml; P〈 〈0.05], and a markedly improved HAMD scorewas significantly improved [（17.65± 6.46） vs. （23.13±5.83）; P〈 0.05 ]. The onset of angina pectoris became less frequently in the treatment group than in the control group was significantly decreased （3 vs.14, , P〈 0.05）. Moreover, no significant difference was found in serum, the value of lipids were no significant difference between the two groups. Conclusion Six months of Anantidepressant treatment for 6 months can markedly relieve the symptom of depression, and can increase the level of APN and inhibit the onset of decrease angina pectoris symptom in peatients with UA and depression after PCI.