CAJ | 학술논문

目的：探讨心力衰竭（心衰）三腔起搏治疗即心脏再同步化起搏治疗（CRT）后焦虑抑郁情绪及心理、药物干预对其的影响。方法40例行心脏再同步化起搏心衰患者术后发生焦虑抑郁情绪[用汉密尔顿焦虑抑郁量表（HAMA和HAMD），测评焦虑抑郁情绪的程度]，将患者随机分为观察组和对照组各20例，6个月时评定焦虑抑郁情绪程度及猝死、心绞痛、心肌梗死、室性心动过速发生率、6 min步行距离、左心室射血分数、左室舒张末径，比较两组统计学差异。结果观察组6 min步行试验距离（540±13.2）m，左心室射血分数（45.31±3.45）%，左室舒张末径（50.2±6.42） mm，显著远（高、短）于对照组的（380±18.5）m、（39.25±4.25）%、（59.3±7.12）mm。观察组猝死、心绞痛、心肌梗死、室性心动过速发生率显著低于对照组（P＜0.05）。观察组焦虑、抑郁改善情况非常显著，低于对照组（P＜0.01）。结论药物联合心理干预治疗心脏再同步治疗心衰患者焦虑抑郁情绪症效果优于常规治疗。
목적：탐토심력쇠갈（심쇠）삼강기박치료즉심장재동보화기박치료（CRT）후초필억욱정서급심리、약물간예대기적영향。방법40례행심장재동보화기박심쇠환자술후발생초필억욱정서[용한밀이돈초필억욱량표（HAMA화HAMD），측평초필억욱정서적정도]，장환자수궤분위관찰조화대조조각20례，6개월시평정초필억욱정서정도급졸사、심교통、심기경사、실성심동과속발생솔、6 min보행거리、좌심실사혈분수、좌실서장말경，비교량조통계학차이。결과관찰조6 min보행시험거리（540±13.2）m，좌심실사혈분수（45.31±3.45）%，좌실서장말경（50.2±6.42） mm，현저원（고、단）우대조조적（380±18.5）m、（39.25±4.25）%、（59.3±7.12）mm。관찰조졸사、심교통、심기경사、실성심동과속발생솔현저저우대조조（P＜0.05）。관찰조초필、억욱개선정황비상현저，저우대조조（P＜0.01）。결론약물연합심리간예치료심장재동보치료심쇠환자초필억욱정서증효과우우상규치료。
Objective To investigate the influences of pharmacotherapy and mental intervention on anxiety and depression in heart failure patients after treating with cardiac resynchronization therapy (CRT). Methods The heart failure patients (n=40) with anxiety and depression after treated with cardiac resynchronization therapy (CRT) were reviewed by using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). All patients were randomly divided into observation group and control group (each n=20). After 6 m, the levels of anxiety and depression, incidence of sudden death, angina pectoris, myocardial infarction and ventricular tachycardia, and 6-minute walk test (6MWT), LVEF and LVEDd were reviewed and compared in 2 groups. Results In observation group, 6MWT [(540±13.2) m vs. (380±18.5) m], LVEF [(45.31±3.45)%vs. (39.25±4.25)%] and LVEDd [(50.2 ±6.42) mm vs. (59.3±7.12) mm] were significantly higher than those in control group. The incidence of sudden death, angina pectoris, myocardial infarction and ventricular tachycardia was significantly lower in observation group than those in control group (P<0.05). The status of anxiety and depression was relieved more significant in observation group compared with control group (P<0.01). Conclusion The efficacy of pharmacotherapy and mental intervention is higher than that of routine therapy in heart failure patients after CRT.