急性心肌梗死合并抑郁症的研究进展

Research Progress of Acute Myocardial Infarction Complicated with Depression

从心肌梗死与抑郁症的关系入手,探讨心肌梗死合并抑郁症的病理生理机制,并对治疗方法进行论述。认为心肌梗死与抑郁症之间的双向关系已经明确,两者相互影响,恶性循环,虽其发病机制尚未明确,但大概包括炎症反应学说、细胞凋亡学说、血小板活化和5-HT作用下丘脑-垂体-肾上腺素轴功能亢进、内皮功能障碍等几种假说。治疗方式主要是在冠心病二级治疗基础上结合抗抑郁药物并辅以非药物疗法。此外“,双心医学”护理模式可通过心理疗法、运动疗法、生物反馈疗法等非药物疗法和药物疗法发挥作用。

The paper explores pathophysiological mechanism of myocardial infarction complicated with depression, and therapeutic methods from the connections between myocardial infarction and depression. It is believed that bidirectional relationship between myocardial infarction and depression has been confirmed, they interacting with each other and forming a vicious circle, though its pathogenesis is not clear yet, roughly containing the theory of inflammatory response, cellular apoptosis, platelet activation, 5-HT-induced hyperfunction of hypothalamic-pituitary-adrenalin axis, endothelial dysfunction and other hypotheses. Therapeutic methods mainly adopt secondary treatment of coronary heart disease and anti-depressant drugs, supplemented by nonpharmaceutical therapy. In addition, nursing mode of psycho-cardiology could work through non-pharmaceutical therapy such as psychological therapy, motortherapy, biofeedback therapy, and drug therapy.