摘要
目的:探讨伴抑郁状态冠心病患者的临床特征和帕罗西汀的临床疗效。
方法:对2008年4月-12月在我院住院的480例冠心病患者应用抑郁自评量表(SDS)进行评分,分析伴抑郁状态冠心病患者的比例和临床特征,对伴抑郁状态的冠心病患者予以分组治疗,观察组单纯使用心血管药物,治疗组在口服心血管药物的基础上分别设立心理辅导、帕罗西汀、心理辅导联合帕罗西汀治疗,比较分析其治疗效果。
结果:1伴抑郁状态冠心病患者占抽样调查冠心病患者的21.6%。2该类患者除了其相应冠心病的症状外,常表现为主诉多,难以缓解的胸闷、胸痛、气促和心悸等症状,血压波动大。3治疗的耐受性和依从性差,单纯使用心血管药物治疗效果欠佳,联合使用心理干预和抗抑郁药物帕罗西汀治疗疗效显著(P<0.001)。
结论:1抑郁状态在冠心病患者中占有很高的比例,对此类患者的主诉应加以分析,注意识别其类似于心血管疾病的躯体化症状。2对此类患者在治疗心血管疾病的同时,应联合给予心理干预及抗抑郁药物治疗。
Objective: To study the proportion, clinical characteristics and treatment of depression in coronary heart disease patients.
Methods: 480 patients in our department from April to December in 2008 were graded by SDS. The proportion and clinical characteristics of patients with coronary heart disease complicating depression were studied. Pations were divied into four groups randomly:control group(single cardio- vascular drugs), treatment groups of mental intervention,single paroxetine and paroxetine combind mental intervention.
Results: 1 21.6% of coronary heart disease patients was complicated with depression.2 Besides the symptoms corresponded to coronary heart disease, this section of coronary heart disease patients have more complaining and particular symptoms, such as chest distress, thoracodynia, breathlessness, palpitation and fluctuation of blood pressure et al, which were all hard to catabatic.3 They responded bad to only routine cardio- vascular drugs treatment. Additional administration of antidepressant drug and mental therapy were effective.
Conclusion: 1 The proportion of depression in coronary heart disease patients is very high. We should identify the symptoms of depression carefully, which is similar to cardiac disease.2 It is important to ad- ministrate antidepressant drug and mental therapy in the treatment of coro- nary heart disease patients with depression.
引文
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