抗焦虑、抑郁治疗对冠心病患者左心功能的影响

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ni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。

The Effect on Left Ventricular Function in Coronary Artery Disease Patients Treated by Anti-Depressive/Anxiety

Objective To evaluate the effect on left ventricular function in coronary artery disease（CAD） patients with anxious and depression treated by psychotherapy combine paroxetine hydrochlofide. Methods CAD patients with anxiety and depression （HAMA scores 〉 14 and/or HAMD scores 〉 17） were randomly divided into two groups. All patients accepted echocardiogram examination and acquired Tei index. The management group accepted psychotherapy, paroxetine hydrochioride and routine drug therapy for CAD while the control group only accepted routine CAD drug therapy. After three months, all patients accepted another Tei index examination and HAMA, HAMD investigation. Results After three months, there was significant difference between two groups in Tei value（ P 〈 0.05 ）. The score of HAMA, HAMD in management group was significantly less than those in control group （ P 〈 0.05 ）. Tei values decreased significantly in management group after three months （ P 〈 0.05 ） but had not significant changes in control group （ P 〉 0.05 ）. Conclusion Left ventricular function of CAD patients with anxiety and depression can be modified by psychotherapy combine paroxetine hydrochloride.