艾司西酞普兰对心脏X综合征合并焦虑抑郁障碍患者的疗效观察

Observation on the efficacy of Escitalopram in the treatment of cardiac syndrome X complicated with anxiety and depression

目的:观察艾司西酞普兰对伴有焦虑抑郁障碍的心脏X综合征(CSX)患者的治疗效果。方法:选择2013年10月至2018年2月在郑州大学附属洛阳中心医院心内科住院的合并焦虑抑郁障碍的CSX患者96例,随机分为治疗组和对照组各48例。两组均接受常规治疗,治疗组加用艾司西酞普兰片,10 mg,1次·d^-1,共用药6个月。比较两组患者治疗后的汉密尔顿焦虑评分(Hamilton Anxiety Scale,HAMA)降低值、17项汉密尔顿抑郁评分(Hamilton Depression Scale-17,HAMD17)降低值、再次住院率、运动试验阳性率、运动试验开始至运动试验阳性时间、血常规、血清内皮素-1水平等指标。结果:治疗组HAMA评分降低值(10.26±3.56)及HAMD17评分降低值(8.5±4.12)均明显高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组运动试验开始至运动试验阳性时间较对照组明显延长,差异有统计学意义(P<0.05)。随访期间治疗组再次入院率为2.12%,对照组为13.04%,差异有统计学意义(P<0.05)。治疗组未出现严重不良反应。结论:对伴有焦虑抑郁障碍的CSX患者,在常规治疗基础上加用艾司西酞普兰,可明显改善患者的心理状态,改善其运动耐量,降低再入院率。

Objective:To observe the efficacy of Escitalopram in treating patients with cardiac syndrome X(CSX combined anxiety and depression.Methods:A total of 96 CSX patients combined with anxiety and depression admitted to the Department of Cardiology,Luoyang Central Hospital Affiliated to Zhengzhou University from October2013 to February 2018 were randomly divided into treatment group and control group,with 48 cases in each group.Both groups received conventional treatment,and the treatment group was additionally treated with Escitalopram tablets,10 mg once a day for a total of 6 months.The reduction of Hamilton Rating Scale for Anxiety(HAMA)and 17 items Hamilton Rating Scale for Depression(HAMD17)after treatment,the rate of re-hospitalization,the rate of tread mill exercise test,the time from the start of exercise test to the positive exercise test,blood routine,endothelin-1 level and other indicators in the two groups were observed respectively.Results:After treatment,HAMA score reduction(10.26±3.56)and HAMD17 score reduction(8.5±4.12)in the treatment group were significantly higher than those in the control group(P<0.05).Compared with the state before the treatment,the time from the start of the exercise test to the positive exercise test was longer in both groups,but the effect of the treatment group was better than control group.During the follow-up period,the readmission rate of the treatment group was 2.12%,which was significantly different from that of the control group(13.04%,P<0.05).No serious adverse reactions was observed in the treatment group.Conclusion:For CSX patients combined with anxiety and depression,the addition of Escitalopram on the basis of conventional treatment can significantly improve the psychological state of patients,improve exercise tolerance,reduce the readmission rate.