|
To observe the acute myocardial infarction (AMI) with depressive disorders by sertraline depression status before and after treatment, cardiac autonomic function, platelet activation, endothelial function and inflammatory factors change, and follow-up the incidence of cardiac events, explore the homes sertraline AMI with the role of aspects of the depressive disorder patients. [Method] in accordance with the inclusion criteria and exclusion standard selection of Cardiology, 70 patients with acute myocardial infarction complicated with depression disorders, divided into intervention group and the control group, 35 cases in each group, all patients were given conventional treatment of medication and psychological support to intervention group were given Sertraline 50mg / d, all patients were followed up for 12 consecutive weeks. Follow-up the incidence of cardiac events; HAD Scale and HAMD Scale score before and after treatment to assess changes in depression; dynamic the electrocardiogram average heart rate and heart rate variability (HRV), assessment of cardiac autonomic nervous system function; dual-antibody sandwich Enzyme-linked immunosorbent assay (ELISA) detection of serum interleukin -6 (IL-6), tumor necrosis factor-α (TNF-α), soluble P-selectin (SP-selectin), nitrate reductase assay of nitric oxide (NO ), measured by radioimmunoassay in plasma endothelin -1 (ET-1) changes observed platelet activity, endothelial function and inflammatory factors change. 【Results】 1, depressive state sertraline significantly improved efficiency and HAMD minus points were significantly better than the control group, with a statistically significant (P lt; 0.01). The incidence of cardiac events in patients with sertraline compared with the control group was significantly reduced, there is a statistically significant (P lt; 0.05). Sertraline, the overall standard of normal sinus RR intervals (SDNN), every five minutes of normal RR intervals mean standard deviation (SDANN), total field values ??(TP), very low frequency (VLF), low frequency (LF) were significantly higher (P lt; 0.01), compared with the same period in the control group was statistically significant (P lt; 0.05). The average heart rate, adjacent RR interval mean square (rMSSD), a difference of more than 50ms adjacent RR interval accounted for a percentage of the total number of RR intervals (PNN50), high-frequency (HF) did not change significantly. 4, sertraline soluble P-selectin (SP-selectin) significantly reduced (P lt; 0.01), compared with the same period in the control group was statistically significant (P lt; 0.05). 5, sertraline increase of NO, ET-1 to reduce, but did not change significantly, no statistically significant comparison with the same period in the control group was not statistically significant. 6, IL-6 and TNF-α in the intervention group and the control group patients were followed for 12 weeks after the treatment, although the trend decrease, but the change is not obvious, was not statistically significant. [Conclusion] sertraline can be raised SDNN, SDANN, TP, VLF, LF, increased heart rate variability in patients, thereby improving cardiac autonomic nerve function. 2, sertraline can reduce the concentration of serum SP-selectin, reduce platelet activity. 3, sertraline does not appear to reduce inflammation and improve endothelial function. 4, application sertraline antidepressant treatment, not only to improve the patient's depression status, but also to reduce the incidence of recent cardiac events. This may reduce platelet reactivity in patients with sertraline, improve the patient's cardiac autonomic nerve function related to the role.
|