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目的观察舍曲林治疗对冠状动脉支架植入术后合并抑郁患者短期预后的影响以及可能的作用机制。方法 76例冠脉支架植入术后合并抑郁的患者在冠心病二级预防基础上被分为舍曲林组和对照组,疗程12 w。观察舍曲林治疗对患者抑郁状态和心血管事件发生情况的影响,以及治疗前后患者血小板活性、炎性细胞因子水平、内皮功能和自主神经功能的变化。结果 67例患者完成随访。舍曲林组抑郁治疗有效率较对照组高(81.3%vs 45.7%,P<0.01),心血管不良事件较对照组少(3.1%vs 20.0%,P<0.05)。舍曲林可降低血小板活性,改善自主神经功能。结论舍曲林在抗抑郁同时,可减少心血管不良事件发生,改善短期预后,这可能与舍曲林降低血小板活性、改善自主神经功能有关。
Objective To investigate the effect of sertraline on the short-term prognosis of patients with coronary artery disease after stent implantation and its possible mechanism. Methods Seventy-six patients with coronary artery disease and coronary heart disease undergoing coronary stent implantation were divided into sertraline group and control group on the basis of secondary prevention of coronary heart disease. The course of treatment was 12 w. To observe the effects of sertraline on depression status and cardiovascular events in patients and the changes of platelet activity, inflammatory cytokines, endothelial function and autonomic nervous function in patients before and after treatment. Results 67 patients completed the follow-up. The sertraline treatment group had a higher rate of depression treatment than the control group (81.3% vs 45.7%, P <0.01). Cardiovascular adverse events were less (3.1% vs 20.0%, P <0.05). Sertraline can reduce platelet activity and improve autonomic function. Conclusions Sertraline can reduce the occurrence of cardiovascular adverse events and improve the short-term prognosis at the same time of antidepressant, which may be related to the reduction of platelet activity and the improvement of autonomic function by sertraline.