氟西汀联合地西泮对ICU急性心肌梗死患者焦虑抑郁情绪及睡眠质量的影响

Effects of fluoxetine combined with diazepam on anxiety,depression and sleep quality in patients with acute myocardial infarction at ICU

目的探讨盐酸氟西汀联合地西泮对重症监护病房(ICU)急性心肌梗死患者焦虑抑郁情绪及睡眠质量的影响。方法选取我院2018年2月~2020年2月期间105例ICU急性心肌梗死患者作为研究对象,采用抽签法分为地西泮组和氟西汀组。地西泮组52例给予地西泮口服治疗,氟西汀组53例在地西泮组基础上给予盐酸氟西汀口服治疗。治疗1个月,对比两组患者焦虑抑郁情绪、内皮功能、睡眠质量及不良反应。结果两组治疗1月末汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分较治疗前均降低,且氟西汀组低于地西泮组(P<0.05)。两组治疗1月末内皮素-1(ET-1)水平较治疗前均降低,且氟西汀组低于地西泮组;一氧化氮(NO)水平较治疗前均升高,且氟西汀组高于地西泮组(P<0.05)。两组治疗1月末匹兹堡睡眠质量指数(PSQI)评分较治疗前均降低,且氟西汀组低于地西泮组;氟西汀组入睡时间、安眠药品使用频次水平低于地西泮组,睡眠时间水平高于地西泮组(P<0.05)。氟西汀组不良反应发生率7.55%(4/53)和地西泮组3.85%(2/52),无明显差异(P>0.05)。结论盐酸氟西汀联合地西泮治疗ICU急性心肌梗死患者,可以改善其睡眠质量,调节其焦虑抑郁情绪,调控其内皮功能,且安全性好。

Objective To explore the effects of fluoxetine hydrochloride combined with diazepam on anxiety,depression and sleep quality in patients with acute myocardial infarction at ICU.Methods A total of 105 patients with acute myocardial infarction at ICU in our hospital from February 2018 to February 2020 were selected as the research subjects,and were divided into diazepam group and fluoxetine group.Fifty-two patients in the diazepam group received oral treatment with diazepam,and 53 patients in the fluoxetine group received oral treatment with fluoxetine hydrochloride in addition to the diazepam group.After 1 month of treatment,the level of anxiety and depression,endothelial function,sleep quality and adverse reactions in two groups were compared.Results The scores of Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)in both groups at the end of 1 month of treatment were lower than those before treatment,and the fluoxetine group was lower than the diazepam group(P<0.05).The level of endothelin-1(ET-1)at the end of 1 month in both groups was lower than that before treatment,and fluoxetine group was lower than diazepam group;The level of nitric oxide(NO)in fluoxetine group was higher than that in the diazepam group(P<0.05).The Pittsburgh sleep quality index(PQI)scores of both groups at the end of 1 month of treatment were lower than those before treatment,and the fluoxetine group was lower than the diazepam group;The level of sleeping time and frequency of sleeping drugs in fluoxetine group were lower than those in diazepam group,and the level of sleeping time in fluoxetine group was higher than that in diazepam group(P<0.05).The incidence of adverse reactions in fluoxetine group was 7.55%(4/53)higher than that in diazepam group(3.85%,2/52),and there was no difference(P>0.05).Conclusion Fluoxetine hydrochloride combined with diazepam in the treatment of ICU patients with acute myocardial infarction can improve their sleep quality,anxiety and depression,and regulate endothelial function with high safety.