老年高血压病患者焦虑抑郁症状的临床特征与治疗.docVIP

精品论文 参考文献 老年高血压病患者焦虑抑郁症状的临床特征与治疗 张智 张林 (成都市第五人民医院心内科 四川成都　611130) 【摘要】目的 探讨老年高血压病患者焦虑抑郁症状的临床特征及治疗。方法　应用心理测试量表(HAMA和HAMD)评估148例老年高血压病患者,对伴有焦虑抑郁症状的患者,给予赛乐特(SSRI)治疗同时给予不同心理治疗方法进行心理干预,在治疗后3w、6w、9w再进行评分。结果　148例患者中,焦虑、抑郁性障碍的发生率分别为33.1%、25.6%,治疗好转率分别为83.6%、86.8%。治疗后3w时HAMA和HAMD积分即较治疗前明显减少,并以6w、9w最为显著。结论 焦虑抑郁性障碍在老年高血压病患者中的发生率较高,抗焦虑抑郁治疗的疗效显著,并与用药（相关治疗）时间有关。 【关键词】老年　高血压　焦虑　抑郁心理治疗赛乐特 【中图分类号】R592 【文献标识码】A 【文章编号】2095-1752（2012）23-0142-02 【Abstract】 Objective: To determine the clinical feature and therapy of the aged with hypertention and anxiety disorder and depressive disorder. Methods: 148 patients with hypertention were assessed by Hamilton anxiety scale (HAMA) and hamilton rating scale for depression (HAMD).The patients with anxiety disorder and depressive disorder accepted SSRI and mental intervention, HAMA and HAMD were assessed immediately at 3,6 and 9 weeks after treatment. Results: Among the 148 patients, the incidence rate of anxiety disorder was 33.1%, depressive disorder was 25.6%. Their improvement rates were 83.6% and 86.8%. The Hamilton anxiety scale and the hamilton rating scale for depression were significantly improved at 3 weeks after treatment, especially at 6 and 9 weeks. Conclusion: There were higher incidencerate in the aged with hypertention and anxiety disorder and depressive disorder. There were significant the rapeutic effect by antianxiety the rapy and related to the rapeutic time. 【Key words】theaged hypertention anxiety depression antianxiety therapy Perez-Stable于1990年研究发现,在老年内科或综合科门诊的病人中,约有50%的重症抑郁障碍未被发现,只有20%的老年抑郁病人得到专科医生治疗[1]。据90年代我国综合性医院的调查,在1673例连续心血管内科门诊病人中,抑郁和焦虑等心理障碍的总患病率达9.7%[2]。对躯体疾病伴焦虑抑郁症状的识别和治疗正日益受到临床医师的重视,也是非精神科医生面临的一个亟需解决的问题。本研究旨在应用对照分析的方法探讨抑郁、焦虑等情绪障碍在老年高血压病患者中的发生频率、严重程度及临床特征及抗焦虑抑郁治疗疗效的观察。为给这类病人提供与躯体治疗相互补益的治疗提供依据。 1 对象与方法 1.1　研究对象　我院2009年至2010年心内科住院或门诊高血压患者148例,男82例,女66例。年龄60～82岁,平均64plusmn;5.8岁。所有患者均符合1999年WHO/ISH高血压诊断标准,并除外心、脑、肾等继发性高血压疾病。