老年高血压患者合并抑郁的早期诊断及帕罗西汀应用安全性研究

目的探讨老年高血压患者合并抑郁的早期诊断及帕罗西汀应用的安全性。方法选择老年高血压患者260例,通过老年抑郁量表和汉密尔顿抑郁量表筛查抑郁状态,并分为抑郁组113例和非抑郁组147例,抑郁组患者随机分为帕罗西汀组56例和心理治疗组57例2个亚组。同时检测血浆5-羟色胺(5-HT)、白细胞介素6(IL-6);观察治疗前后收缩压、舒张压、脉压指数、5-HT、IL-6变化。结果与非抑郁组比较,抑郁组患者血浆5-HT、IL-6含量明显增高(P0.05);与同组治疗前比较,帕罗西汀组和心理治疗组收缩压均明显下降,IL-6也明显下降(P0.05);帕罗西汀组脉压指数较心理治疗组下降明显(P0.05)。结论 5-HT与IL-6可作为老年高血压患者早期诊断抑郁状态的参考指标,帕罗西汀在老年患者应用虽副作用较多,但疗效肯定。

The early diagnosis and safety of paroxetine application in the elderly hypertensive patients complicated with depression

Objective To explore the early diagnosis and safety of paroxetine application in the elderly hypertensive patients complicated with depression.Methods 260 early hypertensive patients were selected.The patients complicated with depressive state were screened with Hamilton depression rating scale and geriatric depression scale,and treated with psychotherapy or anti-depressive medicine randomly.The changes of systolic blood pressure (SBP) ,diastolic blood pressure (DBP),pulse pressure index(PPI) ,5-hydroxytryptamine(5-HT) ,interleukin-6(IL-6) between before and after treatment were observed.Results 113 cases of hypertension complicated with depression were selected.The concentrations of 5-HT and IL-6 in plasma of the elderly hypertensive patients complicated with depression were higher than those in the patients without depression. The SBP,PPI,IL-6 were remarkably decreased,but DBP and 5-HT had no change after paroxetine treatment.Conclusion 5-HT and IL-6 were the early diagnostic indexes of elderly hypertension complicated with depression.The therapeutic effectiveness of paroxetine was confirmed,but it had some side effects in elderly patients.