度洛西汀与西酞普兰治疗慢性心力衰竭伴抑郁焦虑的比较研究

Comparison of duloxetine and citalopram in the treatment of chronic heart failure with depression and anxiety

摘要:

目的 比较度洛西汀和西酞普兰治疗慢性心力衰竭合并抑郁焦虑的临床疗效和安全性。方法 将符合入选标准的57例患者分为研究组29例和对照组28例；研究组给予常规抗心力衰竭治疗+度洛西汀,对照组给予常规抗心力衰竭治疗+西酞普兰,均观察8周。采用综合医院健康问卷抑郁量表－9(PHQ-9)和广泛性焦虑障碍量表－7(GAD-7)对两组进行评价,并在治疗前后监测患者的心功能评价指标及谷丙转氨酶、谷草转氨酶、肌酐、血压、心率等安全性指标。采用SPSS 24.0对数据进行统计分析。计数资料组间比较采用χ²检验或Fisher精确概率法。计量资料组间比较采用t检验或重复测量的方差分析。结果 组内比较,各组治疗后PHQ-9和GAD-7各时点评分存在差异(P<0.05),且随着时间的延长,均呈下降趋势；组间对比,两组治疗后PHQ-9和GAD-7各时点评分变化有统计学差异(P<0.05),研究组PHQ-9和GAD-7评分下降的幅度大于对照组。治疗后两组间心功能各项指标比较均无统计学意义(P>0.05)。各组的安全性指标治疗前后对比无明显差异(P>0.05)。结论 度洛西汀抗抑郁焦虑的疗效优于西酞普兰,对心功能的影响与西酞普兰基本相同,安全性好,可用于慢性心力衰竭合并抑郁焦虑的患者。

Abstract:

Objective To compare the efficacy and safety between duloxetine and citalopram in the treatment of chronic heart failure (CHF) with depression and anxiety. Methods A total of 65 patients meeting the inclusion criteria were randomly divided into study group (n=29) and control group (n=28). The study group received conventional anti-heart failure treatment plus duloxetine, and the control group received conventional anti-heart failure treatment plus citalopram for 8 weeks. The two groups were evaluated using patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7). Patients were monitored for cardiac function, ALT, AST, Cr, BP, HR and other safety indicators before and after treatment. SPSS statistics 24.0 was used for statistical analysis. χ² test or Fisher exact probabilities method was employed for comparison of numeration data and t test or repeated measurement variance analysis for measurement data. Results Intra-group comparison found that the scores of PHQ-9 and GAD-7 at each time point were different after treatment (P<0.01) and tended to decrease with time. Comparison between groups found that the changes of PHQ-9 and GAD-7 at each time point were significantly different after treatment (P<0.05), the decrease of PHQ-9 and GAD-7 at each time point in study group was greater than that in control group. After treatment, there was no significant difference in cardiac function between the two groups (P>0.05). There was no significant difference in safety indicators before and after treatment in each group (P>0.05). Conclusion Duloxetine outperformed citalopram in the treatment of depression and anxiety, and their effect on cardiac function was similar. Duloxetine, with good safety, can be used in CHF patients with depression and anxiety.