CAJ | 학술논문

目的：观察西酞普兰对冠状动脉粥样硬化性心脏病（冠心病）合并抑郁症患者治疗后抑郁状态的改变，对高敏CRP （hsCRP）与心血管事件的影响，评估其安全性。方法将120例确诊为冠心病合并抑郁症患者随机分为对照组（n＝58）和治疗组（n＝62），两组患者均给予冠心病常规治疗加心理干预，治疗组患者加用西酞普兰20 mg/晚，两组患者于治疗前及治疗8周末进行汉密尔顿抑郁量表（HAMD）评分，测定血浆hsCRP，观察心绞痛发作、 AMI、急性心力衰竭发生情况，及不良药物发生情况。结果治疗8周后，治疗组HAMD评分（7.60±3.49）分，与对照组（20.58±3.20）分比较，差异有统计学意义（ P＜0.01）；两组hsCRP均下降，治疗组hsCRP （2.57±0.64） mg/L，对照组（2.90±0.81） mg/L，两组比较差异有统计学意义（ P＜0.05）；治疗组心绞痛发作、AMI、急性心力衰竭发生率分别为10％、2％、2％，对照组分别为18％、5％、9％，两组比较差异有统计学意义（ P＜0.05）。两组治疗前后药物不良反应未见明显差异。结论西酞普兰可以明显改善冠心病症合并抑郁患者的抑郁症状，更显著降低hsCRP水平，降低心血管事件发生率，且药物安全。
목적：관찰서태보란대관상동맥죽양경화성심장병（관심병）합병억욱증환자치료후억욱상태적개변，대고민CRP （hsCRP）여심혈관사건적영향，평고기안전성。방법장120례학진위관심병합병억욱증환자수궤분위대조조（n＝58）화치료조（n＝62），량조환자균급여관심병상규치료가심리간예，치료조환자가용서태보란20 mg/만，량조환자우치료전급치료8주말진행한밀이돈억욱량표（HAMD）평분，측정혈장hsCRP，관찰심교통발작、 AMI、급성심력쇠갈발생정황，급불량약물발생정황。결과치료8주후，치료조HAMD평분（7.60±3.49）분，여대조조（20.58±3.20）분비교，차이유통계학의의（ P＜0.01）；량조hsCRP균하강，치료조hsCRP （2.57±0.64） mg/L，대조조（2.90±0.81） mg/L，량조비교차이유통계학의의（ P＜0.05）；치료조심교통발작、AMI、급성심력쇠갈발생솔분별위10％、2％、2％，대조조분별위18％、5％、9％，량조비교차이유통계학의의（ P＜0.05）。량조치료전후약물불량반응미견명현차이。결론서태보란가이명현개선관심병증합병억욱환자적억욱증상，경현저강저hsCRP수평，강저심혈관사건발생솔，차약물안전。
Objective To study the efficacy , safety and mechanism of Citalopram on coronary artery disease ( CAD) patients with depressive disorder by observing depressive state , Cardiovascular events and high sensitive CRP (hsCRP).Methods We enrolled 120 CAD patients admitted to our hospital with depres-sive disorder.All patients were randomized to control group ( n=58 ) and treatment group ( n=62 ) for 8 weeks.Both groups were given conventional treatment on CAD combined with psychological intervention , Cita-lopram tablets of 20 mg were additionally supplemented to treatment group every night.Hamilton depression rating scale (HAMD) and hsCRP of the patients were measured before treatment and at after 8 weeks’ treat-ment respectively.Adverse drug reaction , angina pectoris attacks , onset of acute myocardial infarction and ep-isodes of acute heart failure of patients were also observed.Results After eight-week treatment , the HAMD score was (7.60 ±3.49 ) in treatment group, (20.58 ±3.20) in control group with significant difference (P<0.05).HsCRP levels were (2.57 ±0.64) mg/L in treatment group and 2.90 ±0.81 mg/L in control group, respectively with significant difference ( P<0.05).Angina pectoris attacks , onset of acute myocardial infarction and Episodes of acute heart failure in treatment group was 10%、 2%、 2%, in control group 18%、5%、 9%, respectively, with statistical significant (P<0.05).There were no significant difference in adverse drug reaction both two groups.Conclusion Citalopram can significantly improve depressive status in CAD pa-tients with depression , and decreased plasma HsCRP and incidence of cardiovascular events , with similar safety between the two groups.