CAJ | 학술논문

目的：探讨西酞普兰对冠心病合并焦虑抑郁患者汉密尔顿抑郁量表（HAMD）、抑郁自评量表（SDS）评分、超敏C反应蛋白（hs‐CRP）、心率变异性（HRV），以及肾素血管紧张素系统（RAS）影响的分析。方法选择2012年1月至2014年8月来该院救治的冠心病合并焦虑抑郁患者160例，按照数字列表法随机平均分为观察组和对照组，其中对照组采用常规治疗方法，观察组在常规治疗的基础上加用西酞普兰，治疗6周后，比较两组患者的临床疗效、HAMD、SDS评分、hs‐CRP、CRP、HRV、RAS情况。结果（1）观察组患者临床总有效率为93．75％明显高于对照组的70．00％（χ2＝10．21，P＜0．05）；（2）观察组HAMD评分、SDS评分、hs‐CRP明显低于对照组，两组差异有统计学意义（t＝12．98、9．43、11．86，P＜0．05）；（3）观察组患者的HRV改善情况明显优于对照组，两组差异有统计学意义（P＜0．05）；（4）观察组患者血管紧张素Ⅱ水平为（93±26）ng／L，对照组患者血管紧张素Ⅱ水平为（37±14）ng／L，比较差异有统计学意义（P＜0．05）。结论西酞普兰应用于冠心病合并焦虑抑郁患者疗效显著，较安全，有临床应用价值。
목적：탐토서태보란대관심병합병초필억욱환자한밀이돈억욱량표（HAMD）、억욱자평량표（SDS）평분、초민C반응단백（hs‐CRP）、심솔변이성（HRV），이급신소혈관긴장소계통（RAS）영향적분석。방법선택2012년1월지2014년8월래해원구치적관심병합병초필억욱환자160례，안조수자렬표법수궤평균분위관찰조화대조조，기중대조조채용상규치료방법，관찰조재상규치료적기출상가용서태보란，치료6주후，비교량조환자적림상료효、HAMD、SDS평분、hs‐CRP、CRP、HRV、RAS정황。결과（1）관찰조환자림상총유효솔위93．75％명현고우대조조적70．00％（χ2＝10．21，P＜0．05）；（2）관찰조HAMD평분、SDS평분、hs‐CRP명현저우대조조，량조차이유통계학의의（t＝12．98、9．43、11．86，P＜0．05）；（3）관찰조환자적HRV개선정황명현우우대조조，량조차이유통계학의의（P＜0．05）；（4）관찰조환자혈관긴장소Ⅱ수평위（93±26）ng／L，대조조환자혈관긴장소Ⅱ수평위（37±14）ng／L，비교차이유통계학의의（P＜0．05）。결론서태보란응용우관심병합병초필억욱환자료효현저，교안전，유림상응용개치。
Objective To explore the affect of citalopram on Hamilton Depression Scale (HAMD) ,self rating Depression Scale (SDS) score ,high sensitive C reactive protein (hs‐CRP) ,heart rate variability (HRV) ,andrenin angiotensin systerm(RAS) levels of patients with coronary heart disease complicated with anxiety‐depression .Methods 160 cases of patients with coronary heart disease and anxiety depression in January 2012 to August 2014 were selected ,they were randomly divided into observation group and control group according to the list of number table methods ,the control group of 80 patients used routine treatment methods ,while 80 patients in observation group were added with citalopram on the basis of conventional therapy ,after 6 weeks of treatment ,the clinical efficacy and changes of the HAMD ,SDS score ,score ,and hs‐CRP ,heart rate variability ,and renin angiotensin levels of two groups were compared .Results (1)The total clinical effective rate of the observation group was 93 .75% ,significantly higher than 70 .0% of the control group ,the difference was statistically significant (χ2 =10 .21 ,P<0 .05);(2)HAMD score ,SDS score ,hs‐CRP of the observation group was significantly lower than that of the control group ,the difference was statistically signifi‐cant(t=12 .98 ,9 .43 ,11 .86 ,P<0 .05);(3)HRV of the study group was significantly higher than that in the control group ,there was a statistically significant difference (P<0 .05);(4)Angiotensin II of the observer group were (93 ± 26)ng/L ,Angiotensin Ⅱ of the control group were (37 ± 14)ng/L ,the difference was statistically significant (P<0 .05) .Conclusion Citalopram has a signifi‐cant efficacy in treatment of patients with coronary heart disease combined with anxiety‐depression ,which is safe and reliable that is worth clinical popularizing and applying .