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目的：探讨舍曲林辅助治疗对抑郁症合并冠心病患者血清炎症因子水平及预后的影响。方法：选择2009 年8 月～2011 年8 月我院收治的86 例抑郁症合并冠心病患者，将其随机分入对照组与观察组，40 例对照组患者接受冠心病常规治疗，46 例观察组患者在常规治疗基础上给予舍曲林口服，每次50～100 mg，每日1 次，疗程24 周。比较两组治疗期间心血管事件发生率、治疗前后汉密尔顿抑郁量表(HAMD)评分及血清炎症因子超敏C- 反应蛋白（hs-CRP）、肿瘤坏死因子-alpha（TNF-alpha）及白介素-6（IL-6）的变化。结果：观察组心血管不良事件发生率显著低于对照组(13.0 %vs 32.5%，P<0.05)；观察组治疗后HAMD 评分、血清hs-CRP、 TNF-alpha及IL-6 水平显著均显著低于对照组(P<0.05)。结论：舍曲林辅助治疗可显著改善抑郁症合并冠心病患者的抑郁状态，降低炎症因子水平并改善其预后。

英文摘要:

Objective:To explore the effect of sertraline on the prognosis and serum cytokines of patients with depressive disorder combined coronary heart disease.Methods:86 cases with depressive disorder combined coronary heart disease were randomly divided into the control group and observation group. 40 patients of the control group were given routine treatment and 46 cases in the observation group received sertraline (50～100mg, qd) oral based on routine treatment for 24 weeks. The incidence of cardiovascular events, HAMD and HAMA scores, serum hs-CRP, TNF-alpha and IL-6 levels were compared between two groups.Results:The incidence rate of cardiovascular events in the observation group was much lower than that in the control group (13.0 % vs 32.5%, P<0.05); the HAMD score after treatment in the observation group was less than that in the control group (P<0.05); compared with the control group, serum hs-CRP, TNF-alpha and IL-6 levels after treatment were greatly decreased (P<0.05).Conclusion:Adjuvant therapy by sertraline may greatly decrease the serum cytokines levels and improve the depressive status and prognosis of patients with depressive disorder combined coronary heart disease.

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