心理干预及抗抑郁药物治疗对高血压病伴抑郁情绪的患者血压和生活质量的影响

目的： 研究心理干预及抗抑郁药物治疗对伴发抑郁情绪的高血压患者的治疗效果及生活质量的影响。方法：对950例高血压患者进行医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HAD）评分筛选，将评分阳性者再进行汉密顿抑郁量表（Hamilton Depression Scale，HAMD）、汉密顿焦虑量表（Hamilton Anxiety Scale,HAMA）评分，将60例汉HAMD表阳性者（HAMD≥20分）随机均分为2组：治疗组采用常规降压治疗、心理干预及抗抑郁药物盐酸帕罗西汀片（赛乐特）治疗；对照组采用常规降压治疗。共观察8周。比较两组治疗后的降压效果、生活质量及抑郁水平。结果：治疗组较对照组的抑郁情绪显著缓解，8周后治疗组HAMD评分由30.03±1.83下降至17.43±1.96; 降压效果更稳定;治疗组平均收缩压及舒张压分别下降26.17及13.63 mmHg，而对照组分别下降14.32及7.18 mmHg；治疗组较对照组生活质量改善更为明显，治疗组生活质量总分由65.97±4.68上升到71.20±5.13。结论：心理干预及抗抑郁药物治疗对伴发抑郁情绪的高血压患者不仅能明显提高生活质量，且对血压的控制较单纯降压药物治疗效果更好。

Effect of antidepressant and psychological intervention on the quality of life and blood pressure in hypertensive patients with depression

ObjectiveTo investigate the effect of antidepressant and psychological intervention on the blood pressure and quality of life in hypertensive patients with depression. MethodsAfter evaluating 950 patients with essential hypertension by Hospital Anxiety and Depression Scale (HAD), patients with HAD positive results were evaluated with Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The positive subjects with HAMD were randomly divided into an antidepressant and psychological intervention group (n=30, including routine treatment, mental state intervention, and antidepressant treatment) and a control group (n=30, routine treatment alone)．The blood pressure, quality of life, and level of depression were compared between the 2 groups. ResultsThe depression symptoms were significantly improved in the antidepressant and psychological intervention group. The HAMD score fell from 30.03±1.83 at entrance to 17.43±1.96 at the end of study. The blood pressure control was more effective in the antidepressant and psychological intervention group than in the control group. The mean systolic blood pressure （SBP） and diastolic blood pressure （DBP）decreased by 26.17 mmHg and 13.63 mmHg in the antidepressant and psychological intervention group, while there were only 14.32 mmHg and 7.18 mmHg decrease in SBP and DBP respectively in the control group. Patients in the antidepressant and psychological intervention group had a higher score in the quality of life. The total score of GQOLI-74 increased from 65.97±4.68 before the treatment to 71.20±5.13 after the treatment. ConclusionPsychological intervention and antidepressant can improve the blood pressure control and quality of life in hypertensive patients with depression