艾司西酞普兰对慢性阻塞性肺疾病合并抑郁焦虑患者的疗效及生存质量的影响

目的研究艾司西酞普兰对慢性阻塞性肺疾病(COPD)患者抑郁焦虑症状疗效及安全性,并评价患者用药前后的生活质量。方法采用汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)(17项)测量心理状况,将总分值分别大于10和12分判定存在轻中度焦虑、抑郁症状的COPD患者共53例分为艾司西酞普兰组(29例)及对照组(24例),治疗4周后再检测患者COPD的各项指标并用圣乔治呼吸问卷(SGRQ)评价生活质量,应用副反应量表(TESS)记录药物副反应。结果①在53例COPD患者中有抑郁症状20例(37.74%),焦虑症状22例(41.51%),抑郁及焦虑症状并存11例(20.75%);②30例男性COPD患者中表现抑郁症状为40.0%(12/30),焦虑症状为43.3%(13/30);23例女性COPD患者中有抑郁症状34.8%(8/23),焦虑症状为39.1%(9/23),两性间差异无统计学意义(P>0.05);③COPD患者治疗前后HAMA及HAMD评分比较:服用艾司西酞普兰治疗前后各阶段的HAMA、HAMD总分下降与治疗前有显著性差异(P<0.05)。FEV1占预计值及FEV1/FVC(%)均有明显改善(P<0.05),生活质量各评分与对照组比较,差异有显著性意义(P<0.05)。结论艾司西酞普兰能改善COPD患者的焦虑及抑郁症状,治疗期间不良反应较少,能明显提高患者的生活质量。

Efficacy and Safety of Escitalopram on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Objective To study the efficacy and safety of escitalopram on depression and anxiety symptoms in patients with chronic obstructive pulmonary disease,and assess the overall quality of life before and after treatment.Methods A total of 53 patients with moderate or severe COPD but stable at base line were divided into routine group and observation group.Efficacy was assessed with the Hamilton rating scale for depression(HAMD-17),the Hamilton rating scale for anxiety(HAMA)and the St.Georges’ Respiratory Questionnaire(SGRQ).In the control group only conventional drugs were used,while in the treatment group,4 weeks of treatment with 10～20 ms/d escitalopram was given besides the routine treatment.The safety of escitalopram was evaluated with adverse reaction scale.Results ①In 53 patients with COPD,There were symptoms of depression in 20 cases(37.74%),anxiety symptoms in 22 cases(41.51%),the coexistence of depression and anxiety symptoms in 11 cases(20.75%).②In 30 cases of male COPD patients,depression symptoms was 40.0%(12/30),anxiety symptoms was 43.3%(13/30);in 23 cases of female COPD patients,depressive symptoms was 34.8%(8/23),anxiety symptoms 39.1%(9/23),there was no significant difference between the sexes(P>0.05).③There were significant differences in HAMA and HAMD scores between before and after treatment in escitalopram group(P<0.05).FEV1% predicted and FEV1/FVC(%)were significantly improved(P<0.05),there was significant difference in quality of life score between two groups(P<0.05).Conclusion Escitalopram can reduce the depression and anxiety in patients with COPD,and improve their quality of life.