心肌梗死合并抑郁的研究进展

摘要

In patients with myocardial infarction, the incidence of depression were between 15% to 30%, about 5 times than normal.Depression is an independent risk factor for coronary heart disease.Studies showed that depression in pa-tients with old myocardial infarction, the risk of death from cardiovascular events increased 2.4-fold, and the risk of its new cardiovascular events will increase twice.Depression had negative impact on the occurrence, development and prognosis of myocardial infarction, which will affect the ability to read and write and receive information of the patient, it decreases the quality of life, and thus undermines the process of re-adaptation of patients who had been discharged and to enable long-term death increased rate.Depression can also affect the patient's lifestyle, platelet activation, endothelial function, causing an in-flammatory reaction, autonomic dysfunction, aggravated heart failure caused by myocardial infarction and other aspects of disa-bility, increased mortality.For the combined depression of myocardial infarction, clinical intervention is very important, psy-chotherapy and drug therapy may be able to improve the prognosis of such patients.%在心肌梗死的患者中,抑郁的发病率为15%~30%,约为正常人的5倍.抑郁还是冠心病的一项独立危险因素.有分析显示,陈旧性心肌梗死的抑郁患者,其心血管事件的死亡风险会增加2抖.4倍,而其新的心血管事件的发生风险会增加2倍.抑郁对心肌梗死的发生、发展及预后存在负性影响,其会影响患者的读写以及接收信息的能力,使其生活质量降低,因而会损害那些已出院患者的重新适应过程以及使远期病死率增加.抑郁还可通过影响患者的生活方式、血小板活性、内皮功能等,引起炎性反应、自主神经功能障碍,加重心功能不全等方面引起心肌梗死患者病残、病死率增加.对于合并抑郁的心肌梗死患者进行临床干预非常重要,心理治疗、药物治疗等可能可以改善此类患者预后.