艾司西酞普兰对慢性阻塞性肺疾病合并抑郁焦虑患者的疗效及生存质量的影响.pdfVIP

1 艾司西酞普兰对慢性阻塞性肺疾病合并抑郁焦虑患者的疗效及生存质量的影响 王立娜（天津市安定医院 精神科，天津 300222） 【摘要】 目的 研究艾司西酞普兰对慢性阻塞性肺疾病（COPD）患者抑郁焦虑症状效及安全性, 并 评价患者用药前后的生活质量。方法 采用汉密尔顿焦虑量表(HAMA) 及汉密顿抑郁量表(HAMD)（17 项）测量心理状况，将总分值分别大于 10 和 12 分判定存在轻中度焦虑、抑郁症状的 COPD 患者共 53例将分为艾司西酞普兰组(29例)及对照组（24例），治疗 4周后再检测患者 COPD的各项指标并用 圣乔治呼吸问卷（SGRQ)评价生活质量，应用 TESS 副反应量表记录药物副反应。结果 ①在 53 例 COPD患者中有抑郁症状 20例(37.74%)，焦虑症状 22例(41.51%)，抑郁及焦虑症状并存 11例(20.75%)。 ②30例男性 COPD患者中表现抑郁症状为 40.0%(12/30)，焦虑症状为 43.3%(13/30); 23例女性 COPD 患者中有抑郁症状 34.8%(8/23)，焦虑症状为 39.1%(9/23)，两性间差异无统计学意义(P＞0.05)。③COPD 患者治疗前后 HAMA及 HAMD评分比较：服用艾司西酞普兰治疗前后各阶段的 HAMA、HAMD总 分下降与治疗前有极显著性差异(P＜0.05)。FEV1占预计值%及 FEV1/FVC(%)均有明显改善(P＜0.05), 生活质量各评分与对照组比较,差异有显著性意义(P＜0.05)。结论 艾司西酞普兰能改善 COPD患者的 焦虑及抑郁症状，治疗期间不良反应较少，能明显提高患者的生活质量。 【关键词】 艾司西酞普兰；慢性阻塞性肺疾病；生存质量；焦虑；抑郁 Efficacy and Safety of Escitalopram on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. Wang Li’na . Tianjin Anding Hospital, Tianjin 300222,P.R.China 【Abstract】Objective To study the efficacy and safety of escitalopram on depression and anxiety symptoms in patients with chronic obstructive pulmonary disease，and assess the overall quality of life before and after treatment. Methods A total of 53 patients with moderate or severe COPD but stable at base line were divided into routine group and observation group. Efficacy was assessed with the Hamilton rating scale for depression(HAMD-17)，the Hamilton rating scale for anxiety (HAMA) and the St.Georges Respiratory Questionnaire (SGRQ). In the control group only conventional drugs were used, while in the treatment group, 4 weeks of treatment with 10～20 ms／d escitalopram was given besides the routine treatment. The safety of escitalopram was evaluated with adverse reaction scale. Results ① In 53 patients with COPD ,There were symptoms of depression in 20 cases (37.74%), anxiety symptoms in 22 cases (41.51%), the coexistence of depression and anxiety symptoms in 11 cases (20.75%). ② In 30 cases of male COPD patients, depression symptoms was 40.0% (12/3