褪黑素在心脏神经官能症患者中的表达水平及治疗作用

The level and therapeutic effect of melatonin in patients with cardiac neurosis

目的探讨早晨血浆褪黑素在心脏神经官能症患者中的表达水平以及补充外源性褪黑素对心脏神经官能症患者的治疗作用。方法连续选择2017年1月至2018年5月在粤北人民医院心内科住院的心脏神经官能症患者共82例作为研究对象,同时收集健康体检者40名作为空白对照组(健康组),所有研究对象早晨抽取静脉血检测其血浆褪黑素表达水平。采用随机数字表法将心脏神经官能症患者分为试验组42例和对照组40例,均行冠状动脉CT血管造影(CTA)或冠状动脉造影排除存在冠心病,所有研究对象住院期间完成焦虑自评量表(SAS)评分,记录常规实验室检查结果。除常规治疗外,试验组睡前1h服用2mg褪黑素,连续服用3个月,对照组则不服用褪黑素。所有患者治疗3个月后门诊复诊,记录治疗效果,并再次进行SAS评分。对结果进行统计分析。结果①褪黑素在心脏神经官能症患者中的表达水平较健康组明显下降[(5.37±2.81)pg/ml比(9.79±3.46)pg/ml,t=2.162,P<0.01]。②治疗前试验组与对照组的SAS评分比较未见统计学差异(60.26±28.28比61.04±28.66,P>0.01),但治疗后试验组SAS评分显著低于对照组(48.73±19.03比54.12±11.26,t=1.625,P=0.04)。试验组治疗有效率高于对照组(90.5%比75.0%,P=0.06),但比较未见统计学差异。结论血浆褪黑素在心脏神经官能症患者中的表达水平明显下降,补充外源性褪黑素能改善心脏神经官能症患者的症状,可能是-种较好的治疗手段。

Objective To investigate the level of plasma melatonin in patients with cardiac neurosis and the therapeutic effect of supplementing exogenous melatonin on the patients.Methods A total of 82 patients with cardiac neurosis,who were hospitalized in Yuebei people's hospital from Jan 2017 to May 2018 were selected as the study subjects,meanwhile 40 healthy peoples were collected as blank control group.Venous blood was extracted from all subjects in the morning to test their plasma melatonin levels.The paticnts with cardiac neurosis,who were excluded from coronary heart disease by coronary artery CT angiography(CTA)or coronary angiography.were randomly divided into 40 cases of control group and 42 cases of experimental group.All subjects completed self-rating anxiety scale(SAS)score during hospitalization.The experimental group received 2 mg of melatoni n 1 hour before bedtime for 3 mon ths,while the control group did not take melatonin.After 3 months of treatment.all patients were revisited to the outpatient department to record the treatment effect and SAS score was performed again.Results(1)Melatonin levels in patients with cardiac neurosis were significantly lower than those in the blank control group[(5.37±2.81)pg/ml vs.(9.79±3.46)pg/ml,t=2.162,P<0.01].(2)There was no statistical difference in SAS score between the experimental group and the control group before treatment(60.26±28.28 vs.61.04±28.66,P>0.01),but SAS score of the experimental group was significantly lower than that of the control group after treatment(48.73 ± 19.03 vs.54.12 ± 11.26,t=1.625,P=0.04).The treatment efficiency of the experimental group was higher than that of the control group(90.5% vs.75.0%,P=0.06)but there was not statistically significant.Conclusion Plasma melatonin level in patients with cardiac neurosis decreased significantly;supplementation with exogenous melatonin can improve the symptoms of the patients,which may be a better treatment.