论文部分内容阅读
目的探讨心理干预联合盐酸帕罗西汀治疗对合并焦虑、抑郁的冠心病患者左室心功能的影响,为该类患者的综合治疗提供依据。方法选取2009年1月-2009年12月心内科住院的冠心病患者。全部患者于入院后3d内行超声心动图左室心功能Tei指数测定及汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分,并将HAMA评分>14分和/或HAMD评分>17分的患者随机分为两组。处理组除常规冠心病二级预防治疗外,还给予心理干预同时结合盐酸帕罗西汀10～20mg/d治疗;对照组仅给予常规冠心病二级预防治疗。3个月后,随访患者再次接受HAMA和HAMD评分和Tei指数测定,比较两组患者治疗前后Tei指数的变化和治疗后量表评分的差异。结果干预3个月后,处理组Tei指数与对照组之间差异有统计学意义(P<0.05),并且HAMA、HAMD评分均较对照组明显降低(P<0.05)。与治疗前相比,处理组Tei指数显著降低(P<0.05),而对照组干预前后Tei指数和HAMA和HAMD两项评分差异均无统计学意义(P>0.05)。结论对合并焦虑、抑郁的冠心病患者进行心理干预同时联合盐酸帕罗西汀治疗,能有效改善患者的焦虑、抑郁状态和左室心功能。
Objective To investigate the effect of psychological intervention combined with paroxetine hydrochloride on left ventricular cardiac function in patients with coronary heart disease complicated with anxiety and depression, and to provide basis for the comprehensive treatment of these patients. Methods From January 2009 to December 2009 in patients with coronary heart disease hospitalized in cardiology. All patients underwent echocardiography with Tei index and Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores of 3d after admission, and HAMA score> 14 and / or HAMD score> 17 Of patients were randomly divided into two groups. In addition to conventional secondary prevention and treatment of coronary heart disease, the treatment group was also given psychological intervention combined with paroxetine 10 ~ 20mg / d treatment; control group only given conventional secondary prevention of coronary heart disease. Three months later, the HAMA and HAMD scores and Tei index were again measured in the follow-up patients. The differences of Tei index and post-treatment scale scores before and after treatment were compared between the two groups. Results Three months after intervention, the difference between Tei index and control group was statistically significant (P <0.05), and HAMA and HAMD scores were significantly lower than those in control group (P <0.05). Compared with those before treatment, the Tei index of the treatment group decreased significantly (P <0.05), while there was no significant difference between the Tei index and the HAMA and HAMD scores before and after treatment in the control group (P> 0.05). Conclusion Psychological intervention combined with paroxetine hydrochloride in patients with coronary heart disease complicated with anxiety and depression can effectively improve the patients’ anxiety, depression and left ventricular function.