摘要
目的观察原发性高血压合并焦虑、抑郁病人应用舍曲林治疗对情绪、血清S100B蛋白(神经组织蛋白质S100)与心肌营养素1(CT-1)及血压的影响。方法选取新乡医学院第二附属医院2015年12月至2017年6月收治的106例原发性高血压合并焦虑、抑郁的病人为研究对象,退出6例,将剩余100例按随机数字表法分为对照组和观察组,所有病人均应用替米沙坦口服,观察组加用舍曲林口服,对照组加用相同剂型的安慰剂口服,持续治疗1月。于治疗前后应用焦虑自评量表(SAS)及抑郁自评量表(SDS)对两组病人焦虑及抑郁症状进行评分,用动态血压仪测定两组病人治疗前后24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、白昼平均收缩压(d SBP)、夜间平均收缩压(nSBP)、白昼平均舒张压(dDBP)及夜间平均舒张压(n DBP),并用酶联免疫吸附法检测血清S100B、CT-1水平。结果观察组治疗后SAS、SDS评分分别为(39.7±6.7)分、(38.4±5.3)分,对照组分别为(64.7±5.8)分、(58.1±4.9)分,观察组治疗后SAS、SDS评分低于对照组(t=19.965,19.369,均P<0.001);观察组治疗后24 h SBP、24hDBP、dSBP、nSBP、dDBP、nDBP分别为(118.2±6.7)、(78.3±6.6)、(124.1±7.3)、(112.3±6.1)、(82.5±6.8)、(74.1±6.4)mmHg,对照组分别为(121.7±7.1)、(82.3±7.2)、(127.2±8.1)、(116.2±5.7)、(85.2±6.6)、(79.4±7.8)mmHg,观察组治疗后24 h SBP、24 h DBP、dSBP、nSBP、d DBP、nDBP水平低于对照组(t=2.535,P<0.05;t=2.896,P<0.05;t=2.010,P<0.05;t=3.303,P<0.01;t=2.012,P<0.05;t=3.714,P<0.001);观察组治疗后血清S100B、CT-1分别为(60.6±13.4)pg/mL、(47.8±12.5)ng/L,对照组分别为(88.4±15.7)pg/mL、(56.7±11.2)ng/L,观察组治疗后血清S100B、CT-1水平低于对照组(t=7.468,3.751,均P<0.001)。结论舍曲林能有效改善原发性高血压合并焦虑、抑郁病人的焦虑、抑郁情绪,并辅助降低血压,从而血清S100B、CT-1水平下降。
Objective To observe the effects of sertraline on emotion,S100 B protein,cardiotrophin-1(CT-1)and blood pressure in patients with essential hypertension combined with anxiety and depression.MethodsOne hundred and six patients with essential hypertension combined with anxiety and depressionwho were admitted to the Second Affiliated Hospital of Xinxiang Medical University from December 2015 to June 2017 were selected as the research objects,leaving 6 cases,the remaining 100 cases were randomly assigned into the control group and the observation groupaccording to random number table method.The observation group was treated telmisartan orally combined with sertraline,while the control group was treated telmisartan orally combined with placebo of the same dosage form,the treatment lasted for 1 month.Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to evaluate the anxiety and depressive symptoms of the two groups before and after treatment.The 24-hour mean systolic blood pressure(24-hour SBP),24-hour mean diastolic blood pressure(24-hour DBP),daytime mean systolic blood pressure(dSBP),nighttime mean systolic blood pressure(nSBP),daytime mean diastolic blood pressure(dDBP)and nighttime mean diastolic blood pressure(nDBP)were measured by ambulatory blood pressure meter before and after treatment.Serum S100 B and CT-1 levels were measured by enzyme-linked immunosorbent assay.ResultsThe SAS[(39.7+6.7)vs.(64.7+5.8)]and SDS[(38.4+5.3)vs.(58.1+4.9)]scores after treatment in the observation group were significantly lower than those in the control group(t=19.965,19.369,all P<0.001).The 24-hour SBP[(118.2±6.7)mmHg vs.(121.7±7.1)mmHg],24-hour DBP[(78.3±6.6)mmHg vs.(82.3±7.2)mmHg],dSBP[(124.1±7.3)mmHg vs.(127.2±8.1)mmHg],nSBP[(112.3±6.1)mmHg vs.(116.2±5.7)mmHg],dDBP[(82.5±6.8)mmHg vs.(85.2±6.6)mmHg]and n DBP[(74.1±6.4)mmHg vs.(79.4±7.8)mmHg]after treatment in the observation group were significantly lower than those in the control group(t=2.535,P<0.05;t=2.896,P<0.05;t=2.010,P<0.05;t=3.303,P<0.01;t=2.012,P<0.05;t=3.714,P<0.001).The serum S100 B[(60.6±13.4)pg/mL vs.(88.4±15.7)pg/mL]and CT-1[(47.8±12.5)ng/L vs.(56.7±11.2)ng/L]after treatment in the observation group were significantly lower than those in the control group(t=7.468,3.751,all P<0.001).ConclusionsSertraline can effectively improve the anxiety and depression of patients with essential hypertension complicated with anxiety and depression,assist in lowering blood pressure,and decrease the level of serum S100 B and CT-1.
作者
魏旭明
张寒雪
王宁
张三强
杜明君
任明芬
WEI Xuming;ZHANG Hanxue;WANG Ning;ZHANG Sanqiang;DU Mingjun;REN Mingfen(Department of Cardiology,The Second Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453002,China;Henan Medical Tissue Regeneration Laboratory,Xinxiang,Henan 453000,China;Xinxiang Key Laboratory of Heart and Mental Health Research,Xinxiang,Henan 453000,China)
出处
《安徽医药》
CAS
2020年第10期2075-2078,共4页
Anhui Medical and Pharmaceutical Journal
基金
河南省高等学校重点科研项目(16B320018)。
