艾司西酞普兰治疗老年慢性心力衰竭伴抑郁症对患者认知功能和心功能的影响

Influences of escitalopram on cognitive function and cardiac function in elderly patients with chronic heart failure complicated with depression disorder

目的探索治疗老年慢性心力衰竭(CHF)合并抑郁障碍时在常规内科治疗基础上加用艾司西酞普兰对认知功能和心功能的近期影响。方法选取2014年10月至2015年10月重庆市第九人民医院收治的97例CHF合并抑郁障碍患者,随机分为抗抑郁组和对照组。抗抑郁组在常规内科治疗基础上加用艾司西酞普兰,对照组则加用安慰剂。治疗前和治疗6周末采用24项汉密尔顿抑郁量表(HAMD-24)、14项汉密尔顿焦虑量表(HAMA-14)、蒙特利尔认知评估量表(MoCA)评估患者的抑郁、焦虑程度和认知功能,并检测患者血浆N-末端脑利钠肽原(NT-proBNP)水平、左心室舒张末内径(LVEDD)及左心室射血分数(LVEF)。结果治疗6周末,抗抑郁组HAMD-24和HAMA-14得分、血浆NT-ProBNP水平低于对照组,注意得分和LVEF高于对照组,差异均有统计学意义(P<0.05);其余各项观察指标比较,差异无统计学意义(P>0.05)。结论艾司西酞普兰治疗老年CHF合并抑郁障碍不仅能缓解患者的焦虑抑郁情绪,还能促进患者心功能和注意的改善。

Objective To explore the short-term influences of conventional internal medical treatment combined with escita- lopram on cognitive function and cardiac function in elderly patients with chronic heart failure （CHF） complicated with depression disorder. Methods A total of 97 patients with CHF complicated with depression disorder in Chongqing Ninth People＇s Hospital, from October 2014 to October 2015, were selected and randomly divided into the antidepressant group and control group. Both groups were undergoing conventional internal medical treatment. Additionally, patients in the antidepressant group were administra- ted with escitalopram,while patients in the control group were treated with placebo. The degree of depression and anxiety and cog- nitive function were assessed by using 24-item Hamilton depression scale （HAMD-24）, 14-item Hamilton anxiety scale （HAMA- 14） and Montreal cognitive assessment（MoCA） scale,and the plasma level of NT-proBNP,left ventricular end-diastolic dimension （LVEDD） and left ventricular ejection fraction （LVEF） were measured before and after 6-week treatment. Results After 6-week treatment,the HAMD-24 and HAMA-14 scores and plasma level of NT-proBNP in antidepressant group were lower than those in the control group,while the attention score and LVEF were greater than those in the control group,there were statistically signifi- cant differences（P〈0.05）. After 6-week treatment, no statistically significant difference was found in other observed indicators be- tween the two groups（P〉0.05）. Conclusion For elderly patients with chronic heart failure complicated with depression disorder, it is indicated that escitalooram could not onlv relieve their anxiety and depression, but also improve their cardiac function and attention.