氢溴酸西酞普兰对老年舒张性心衰伴抑郁患者生活质量的影响

目的探讨氢溴酸西酞普兰结合常规抗心衰治疗对老年舒张性心力衰竭(DHF)伴抑郁患者生活质量的影响。方法入选2014年1月至2015年3月内江市第二人民医院89例老年DHF伴抑郁患者,根据用药情况分为氢溴酸西酞普兰组和盐酸阿米替林组,常规抗心衰治疗基础上氢溴酸西酞普兰组患者口服氢溴酸西酞普兰片10~20 mg/次,1~2次/d,每天剂量不超过40 mg;盐酸阿米替林组患者口服盐酸阿米替林片25 mg/次,2~3次/d,最高每天不超过300 mg(12片),维持量每天50~150 mg(2~6片),连续治疗8周。结果相比服药前,两组患者服药8周后左心室射血分数(LVEF)、6分钟步行试验(6MWT)值提高,左心室舒张末期内径(LVEDd)值和汉密尔顿抑郁量表(HAMD)评分降低,活动、日常生活、健康、近期支持、总体精神及生存质量指标评分提高(P0.05)。治疗后相比盐酸阿米替林组,氢溴酸西酞普兰组患者抑郁改善显著,差异有统计学意义(P0.05)。两组患者不良反应发生率差异无统计学意义(x2=0.362,P=0.547)。结论氢溴酸西酞普兰结合常规抗心衰治疗可显著改善老年DHF伴抑郁患者症状,提高患者的生活质量。

Effect of citalopram hydrobromide on quality of life in diastolic heart failure elderly patients with depression

Objective To determine the effect of citalopram hydrobromide combined with conventional anti-heart failure therapy on the quality of life in the elderly patients with diastolic heart failure (DHF) and depression. Methods A total of 89 elderly DHF patients with depression admitted in our hospital from January 2014 to March 2015 were recruited in this study. According to their treatment, they were divided into citalopram hydrobromide group and amitriptyline hydrochloride group. On the basis of conventional anti-heart failure therapy, citalopram hydrobromide tablets were taken orally in the former group at 10-20 mg once, once to twice a day, with a daily dose not larger than 40 mg, and amitriptyline hydrochloride tablets were administered orally in the latter group at 25 mg once, twice to 3 times a day, with a daily dose no more than 300 mg (12 tablets), and maintenance dose of 50-150 mg (2 to 6 tables) for a continuous treatment for 8 weeks. Results Compared with before treatment, the value of left ventricular ejection fraction (LVEF) and the result of 6-minute walking test (6MWT) were improved after 8 weeks of treatment, the value of left ventricular end diastolic dimension (LVEDd) and score of Hamilton Depression Scale (HAMD) were decreased, and the scores of activities, daily life, health, recent support and general spirit were increased in the patients of both groups (P<0.05). Compared with the amitriptyline hydro-chloride group, the improvements of depression were more significant in the citalopram hydrobromide group (P<0.05). There was no significant difference in the incidence of adverse reactions between the 2 groups (Chi-square=0.362, P=0.547). Conclusion Citalopram hydrobromide combined with conventional anti-heart failure therapy can significantly attenuate the symptoms and improve the quality of life in the elderly DHF patients with depression.