摘要
目的探讨焦虑、抑郁状态与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的关系,以及氟哌噻吨美利曲辛对冠状动脉慢血流现象合并焦虑、抑郁患者的治疗效果。方法选取2015年1月-2018年8月于解放军第305医院行冠状动脉造影检查诊断为冠状动脉造影血管正常且血流正常患者120例(正常组)和冠状动脉慢血流现象患者120例(CSFP组),比较两组抑郁自评量表(PHQ-9)及焦虑自评量表(GAD-7)评分结果。进一步从冠状动脉慢血流现象组(CSFP组)筛选出合并焦虑或者抑郁患者共54例,将这些筛选出的合并焦虑、抑郁的患者按随机数字表法进一步分为对照组27例及观察组27例,对照组给予阿司匹林等常规治疗,观察组在常规治疗基础上加用氟哌噻吨美利曲辛。疗程为6个月,观察两组治疗后的临床疗效。结果与正常对照组相比,冠状动脉慢血流现象组抑郁和焦虑状态得分更高:冠状动脉慢血流现象组的GAD-7评分、PHQ-9评分均显著高于正常组(6.44±2.91 vs 4.37±2.15;7.41±2.23 vs 4.52±1.91;P均<0.05),提示焦虑、抑郁与冠状动脉慢血流现象具有相关性。此外,对于合并焦虑、抑郁冠状动脉慢血流现象患者,氟哌噻吨美利曲辛具有良好疗效。两组焦虑抑郁患者治疗前基线资料差异无统计学意义;经治疗后,观察组GAD-7评分、PHQ-9评分均显著下降,且低于对照组(4.44±2.47 vs 12.78±3.53;4.81±2.32 vs 16.04±4.25;P均<0.05),各支冠状动脉(包括前降支、回旋支、右冠状动脉)血流速度及平均CTFC均较治疗前明显提高(P均<0.05);观察组SF-36量表各项评分(生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康等)均显著高于对照组(P均<0.05)。结论焦虑、抑郁与冠状动脉慢血流现象具有明显相关性,氟哌噻吨美利曲辛可明显缓解患者焦虑、抑郁状况,提高冠脉血流速度,改善患者生活质量,提高临床疗效。
Objective To explore the relationship between anxiety,depression and coronary slow flow phenomenon(CSFP),and the therapeutic effect of Deanxit(Flupentixol and Melitracen Tablets)in patients with coronary slow flow phenomenon combined with anxiety and depression.Methods From January 2015 to August 2018,120 patients with coronary slow flow phenomena(CSFP group)and 120 patients with normal coronary artery and normal blood flow(normal group)were examined by coronary angiography in 305 Hospital of PLA.Self-rating depression scale(PHQ-9)and self-rating anxiety scale(GAD-7)were used to evaluate the level of anxiety and depression.Fifty-four CSFP patients with anxiety and depression were screened and further divided into control group(n=27)and observation group(n=27)according to random number table method.The control group was given routine treatment(aspirin),while the observation group was given Deanxit on the basis of the routine treatment.The course of treatment was 6 months.The clinical efficacy was observed after treatment.Results The GAD-7 score,PHQ-9 score in the coronary slow flow phenomenon group were significantly higher than those of the normal group(GAD-7,6.44±2.91 vs 4.37±2.15;PHQ-9,7.41±2.23 vs 4.52±1.91;P<0.05,respectively).After treatment with Deanxit,the GAD-7 score and PHQ-9 score in the observation group decreased significantly,and were significantly lower than those in control group(GAD-7,4.44±2.47 vs 12.78±3.53;PHQ-9,4.81±2.32 vs 16.04±4.25;P<0.05,respectively)and the blood flow velocity of each coronary artery in the observation group,including anterior descending branch,the circumflex branch,right coronary artery and average CTFC,were significantly higher than those before treatment(all P<0.05).The scores of SF-36 scale(physical functioning,role physical,bodily pain,general health,vitality,social functioning,role emotional and mental health)in the observation group were significantly higher than those in the control group(all P<0.05).Conclusion Both anxiety and depression are correlated with CSFP.Deanxit can significantly relieve the anxiety and depression in patients with CSFP,improve the coronary blood flow speed and the quality of life.
作者
李巍
柳杨
杜大勇
李运田
LI Wei;LIU Yang;DU Dayong;LI Yuntian(Department of Cardiology,305 Hospital of PLA,Beijing 100017,China)
出处
《解放军医学院学报》
CAS
2020年第7期687-692,共6页
Academic Journal of Chinese PLA Medical School
基金
解放军第305医院院内青年基金项目(17YQ03)
