老年慢性充血性心力衰竭合并抑郁症患者的临床研究

目的 探讨抑郁症在老年慢性充血性心力衰竭(CHF)患者中的患病率情况及对预后的影响,观察综合治疗对患者抑郁状态及心功能的影响.方法 应用抑郁自评量表(SDS)评价264例老年CHF患者,将其中123例并发抑郁的患者随机分成治疗组62例和对照组61例,对照组给予常规心血管药物治疗,治疗组在常规心血管药物治疗的基础上进行综合治疗,包括抗抑郁药物治疗和心理干预,疗程3个月.治疗前后应用SDS、左心室射血分数(LVEF)、血浆N末端脑型利钠肽(NT-pro BNP)浓度、心功能进行评价,并分析各组CHF患者平均住院天数、再入院率、病死率的差异.结果 治疗组治疗后平均住院时间(23.35±6.76)天、再入院率(29.0%)、病死率(4.8%)、SDS评分(41.71±3.72)分、NT-pro BNP(2 724.21±845.17)ng/L均比对照组明显降低(P<0.05或P<0.01),LVEF(48.76±5.07)%明显增加,心功能明显改善(P<0.05).结论 抑郁症在老年CHF中的患病率高达46.6%,是心力衰竭患者预后不良的重要危险因子.综合治疗CHF患者的抑郁症疗效好,安全性高.

Depressive disorder in hospitalized patients with gray-haired chronic heart failure

Objective To discuss the influence of depressive disorder in disease rate and prognosis of patients with gray-haired chronic heart failure（CHF） and observe effectiveness of the comprehensive treatment on these patients.Methods 264 patients with CHF were scored by Self-rating Depression Scale（SDS）.Among them,123 CHF with depressive disorder patients were divided into comprehensive treatment group（n=62） and general group（n=61）.Three months later,they were compared in mortality,rehospitalization rate,average stay.They were scored by SDS,left ventricular ejection fraction（LVEF）,N-terminal pro-brain natriuretic peptide（NT-pro BNP）,heart function were evaluated.Results The comprehensive treatment group was lower than general group in average stay（23.35±6.76） days,rehospitalization rate（29.0%）,mortality rate（4.8%）,SDS（41.71±3.72） scores,NT-pro BNP（2 724.21±845.17） ng/L（P0.05 or P0.01）.LVEF（48.76±5.07）% was higher than that of general group（P0.05）.Conclusion The incidence of depressive disorder in patients with CHF is higher（46.6%）,it is an important risk for poor prognosis of CHF patients.The comprehensive treatment is safe and effective in the treatment of depression disorder.