艾司西酞普兰对冠心病伴焦虑、抑郁患者炎症因子水平及血管内皮功能的影响

The Effect of Escitalopram on the Level of Inflammatory Factors and Endothelial Function in Patients with Coronary Heart Disease Accompanied by Anxiety and Depression

【目的】探讨艾司西酞普兰对冠心病伴焦虑、抑郁患者机体炎症因子水平及血管内皮功能的影响。【方法】选择2021年7月至2022年7月两院收治的112例冠心病伴焦虑、抑郁患者,根据随机数字表法将其分为观察组、对照组,每组56例。对照组给予常规药物治疗,观察组在对照组的基础上联合艾司西酞普兰治疗。比较两组治疗前后血管内皮功能[内皮素(ET-1)、血管内皮生长因子(VEGF)、一氧化氮(NO)]、炎症因子[白细胞介素-2(IL-2)、C反应蛋白(CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)]、神经递质[脑源性神经营养因子(BDNF)、去甲肾上腺素(NE)、5-羟色胺(5-HT)]、认知功能[Loewenstein认知功能评定量表(LOTCA)评分]及汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分。【结果】治疗后,观察组ET-1、TNF-α、IL-8、CRP、IL-2低于对照组,NO、VEGF高于对照组(P<0.05);治疗后,观察组BDNF、NE、5-HT水平均高于对照组(P<0.05);治疗后,观察组LOTCA各项评分及总分高于对照组(P<0.05);治疗后,观察组HAMD、HAMA评分均低于对照组(P<0.05)。【结论】艾司西酞普兰对冠心病伴焦虑、抑郁患者负性情绪改善效果显著,可降低机体炎症反应,改善血管内皮功能。

【Objective】To investigate the effect of escitalopram on the levels of inflammatory factors and vascular endothelial function in patients with coronary heart disease accompanied by anxiety and depression.【Methods】A total of 112 patients with coronary heart disease accompanied by anxiety and depression admitted to two hospitals from July 2021 to July 2022 were selected and randomly divided into an observation group and a control group according to a random number table method,with 56 cases in each group.The control group was given conventional drug treatment,while the observation group was treated with escitalopram on the basis of the control group.The vascular endothelial function[endothelin-1(ET-1),vascular endothelial growth factor(VEGF),nitric oxide(NO)],inflammatory factors[interleukin-2(IL-2),C-reactive protein(CRP),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)],neurotransmitters[brain-derived neurotrophic factor(BDNF),norepinephrine(NE),serotonin(5-HT)],cognitive function[Loewenstein Cognitive Assessment Rating Scale(LOTCA)score],Hamilton Depression Rating Scale(HAMD)score,and Hamilton Anxiety Rating Scale(HAMA)score were compared before and after treatment between the two groups.【Results】After treatment,the levels of ET-1,TNF-α,IL-8,CRP,and IL-2 in the observation group were lower than those in the control group,while NO and VEGF were higher than those in the control group(P<0.05).After treatment,the levels of BDNF,NE,and 5-HT in the observation group were higher than those in the control group(P<0.05).After treatment,the LOTCA scores and total scores in the observation group were higher than those in the control group(P<0.05).After treatment,the HAMD and HAMA scores in the observation group were lower than those in the control group(P<0.05).【Conclusion】Escitalopram has significant effect on improving negative emotions in patients with coronary heart disease accompanied by anxiety and depression,which can reduce the inflammatory response and improve vascular endothelial function.