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慢性缺血性心力衰竭患者抑郁障碍与血管内皮功能的评估分析
丁茹,陈金明*
0
(第二军医大学长征医院心内科,上海 200003)
摘要:
\[摘要\]目的探讨慢性缺血性心力衰竭伴发抑郁障碍患者血管内皮功能的状态。方法对56例临床症状稳定的慢性缺血性心力衰竭患者Zung抑郁自评量表(SDS)进行抑郁障碍评估,根据SDS标准分分为抑郁障碍组(n=20)、非抑郁障碍组(n=36),分别用超声检测肱动脉血流介导的血管舒张(FMD),同时检测血浆NO、ET-1水平,比较两组之间血管内皮功能的差异。结果56例慢性缺血性心衰患者中抑郁障碍发生率35.7%;抑郁障碍组FMD参数即反应性充血后肱动脉内径变化率\[(5.97±0.78)%\]、血浆NO水平\[(48.90±9.82) μmol/L\]低于非抑郁障碍组\[(6.66±0.83)%、(55.13±10.32) μmol/L,均P<0.05\],血浆ET-1水平\[(83.35±13.39) ng/L\]高于非抑郁障碍组\[(74.67±10.95) ng/L,P<0.05\]。结论慢性缺血性心力衰竭伴抑郁障碍者血管内皮功能受损程度较非抑郁障碍者更为严重。
关键词:  抑郁  心力衰竭  血管内皮  冠心病
DOI:10.3724/SP.J.1008.2010.01319
投稿时间:2010-07-27修订日期:2010-12-02
基金项目:
Analysis of depression and endothelial function in patients with chronic ischemia heart failure
DING Ru, CHEN Jin-ming*
(Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China)
Abstract:
\[Abstract\]ObjectiveTo investigate the endothelial function of chronic ischemia heart failure (CIHF) patients complicated with depression. MethodsThe depression statuses were evaluated by Self-rating Depression Scale (SDS) in 56 patients with documented stable chronic ischemia heart failure. The patients were assigned to depression group (n=20) or non-depression group(n=36) based on their standard SDS scores. The flow-mediated dilation(FMD) of the brachial artery was assessed by ultrasound in the two groups, and the plasma ET-1 and NO levels were determined so as to evaluate the endothelial function. ResultsThe incidence of depression was 35.7% in the 56 patients. Patients in the depression group showed significantly lower FMD compared with the non-depression group(\[5.97±0.78\]% vs \[6.66±0.83\]%, P<0.05). Plasma NO level (\[48.90±9.82\] μmol/L vs \[55.13±10.32\] μmol/L, P<0.05) was lower and ET-1 level (\[83.35±13.39\] ng/L vs \[74.67±10.95\] ng/L, P<0.05) was higher in the depression group than in the non-depression group.ConclusionCIHF patients with depression have a more severe damage of endothelial function than those without depression.
Key words:  depression  heart failure  vascular endothelium  coronary disease