心脏病与抑郁障碍的认识及处理.pdfVIP

医学综述2008年4月第l4卷第7期 Me~ca1 Recapitulate，Apr2008，Vo1．14，No．7 · 1057· 心脏病与抑郁障碍的认识及处理 于永涛 (山东省青岛市麦岛精神病院四病房，山东青岛266071) 中图分类号：R541；R749．23 文献标识码：A 文章编号：i006-2084(2008)07—1057—02 摘要：抑郁障碍与心脏疾病的关系大致有5个方面：因果关系、反应关系、诱发关系伴发关系、药 患者的动脉内皮功能，也可以诱 物因素。二者在不同的关系下，其处理方式亦有所不同。因果关系，治疗以心脏病为主；反应关．系， 导胰岛素抵抗，增加患者罹患心 心理治疗为主，必要时加用抗 抑郁药；诱发、伴发关系，心脏病和 抗抑郁治疗并重，辅以心理治疗；药 血管疾病的危险性 J。 物关系，抗抑郁药物减量。因此，为了给患者选择更恰当的治疗方式，有必要分清二者的5种关系。 抑郁性情绪的存在和心脏病 关键词：心脏疾病：抑郁障碍；抗抑郁药 的发作往往相互影响、相互作用、 Recognltion and Measurement of．Heart Diseases and Depressive Disorder yU y0 一tao．(Fourth 相互强化。如心脏病患者可出现 Ward，Qingdao Maidao Mental Hospital in Shandong，Qingdao 266071，China) Abstract：The relationship between depressive disorder and hea rt disease aD proximately lies in 5 as— 情绪低落、注意力不集中、记忆力 peers，that is causal relationship，r~ponsive relations hip，inductive relationship，accompaniment relationship 下降、睡眠障碍、疑病观念等；同 and drug factors．The me asureme~depends on the different relationship between them．As for causal relation- ship．the treatment should based on tIle treatment for heart di$ease．while．therapeutic emphasis should be put 时抑郁情绪又会对冠状动脉粥样 Oil treatment for psych otherapy，accompany with antidepressant if needed．Combined therapy for heart di sease 硬化性心脏病的发生、发展产生 and antidepressive therapy assisted by psychotherapy should be put on tIle induction and accompaniment tela． tionship．At last，to deereas the dosage of the used drugs is needed in the therapy for drug relationship．So，it is 负性影响，增加急性心肌梗死患 needed to classify these 5 kinds of relationship in order to select the MOre correct ther apy for patients． 者的病死率。心肌梗死后抑郁症 Key words：Heart diseases；Depressive disorder；Antidepmssa