【《抑郁与冠心病的研究进展综述论文》4200字】

1 2 2 2 3 3 3 4 4 5 参考文献 6发病机制、早期筛查、治疗方案等几个方面进行综述。关键词：冠心病、抑郁、机制、治疗抑郁是冠心病(Coronaryheartdisease,CHD)发生、发展的独立危险因素，在CHD患者中高发。有研究表明，每5名CHD患者中就有1人患有抑郁症，其抑郁共病的现象越来越受到临床医师的关注。新诊断的CHD患者若合并重度抑郁症，其心血管不良事件的风险在12个月内会增加一倍3。先前的研究也显示，CHD患者抑郁症状与心脏事件之间存在剂量-反应关系，即使抑郁症症状的轻微增加，也AMI入院患者长达12个月的随访研究显示，260名抑郁症患者的直接医疗费用比非抑郁症患者高41%,原因是门诊费用增加，急诊就诊次数增多，心源性再入院时间延长。在654名疑似CHD的女性中，轻度至中度抑郁症患者的总体心血管治疗费用比对照组高33%,单药物治疗费用就比对组高21%。而总社会成2.CHD患者合并抑郁的可能发病机制心率变异性(Heartratevariability,HRV)的降低与该调节功能受损有关。而心率增快与HRV的降低均可诱发心源性猝死¹。2.4下丘脑-垂体-肾上腺轴激活、炎症和氧化应激2.5内皮功能损伤和血小板激活减弱7。2.6肠道微生物群2.7内分泌机制3.CHD患者合并抑郁的早期筛查4.CHD患者合并抑郁的治疗CHD患者合并抑郁的药物治疗可以有效缓解其抑郁情绪33,但无法减轻抑郁发生、发展，但其相关机制仍需进一步的基础实验前中药联合抗抑郁药物治疗并未在临床上较大范围应用，相关副作用尚未可[1]LaneD,CarrollD,RingC,etal.Theprevalenceandpersisandanxietyfollowingmyocardialinfarction[J].Britishjournalofhealthpsychology,2002,7(Pt1):11-21.qualityoflife:theHeartandSoulStudy[3]CarneyRM,RichMW,FreedlandKE,etal.Majordepressivedisorderpredcardiaceventsinpatientswithcoronaryartermedicine,1988,50(6):627-633.factor[J].Psychosomaticmedicine,2005,duringthefirstyearfollowingmyocardialinpsychosomaticresearch,2000,48(4-5):471-478.[6]RutledgeT,VaccarinoV,JohnsonBD,etal.DepressionandhealthcarecostsamongwomenwithsuspectedmyoStudy[J].JournaloftheAmericanCollegeofCardiology,2009,53(2):176-183.[7]ConsoliSM,CordierS,DucimetierePJPM.ApsycholfortheriskfordepressionintheFrenchGAZELcohort[J].PsychMedicine,1997,59.associatedwithcoronaryplaquevulnerab[9]ZornJV,SchürRR,BoksMP,etal.disorders:Asystematicreviewandmeta-analysis[J].Psychoneuroendocrinology,2017,7[10]李爱民.冠心病患者心理抑郁的相关研究进展[J].I,SzabóBM,etal.Depressionandafheartratevariabilityaftermyocardialinfarction[J].Psychologicalmed2008,38(3):375-383.onleukocytesubsetdistributioninhNeuropsychobiology,1999,39(1):1-9.[13]SeverusWE,LittmanAB,StollAL.Omega-3fattyacids,homocysteine,theincreasedriskofcardiovascularmortalityinmajordeprHarvardreviewofpsychiatry,2001,9(6):280-293.[14]deAlmeidaKM,MoreiraCL,LaferB.Metabolicsyndromeawhatshouldpsychiatristsknow?[J].CNSneurosc2012,18(2):160-166.[15]MusselmanDL,TomerA,Maninmajordepression[J].TheAmericanjournalofpsychiatry,[16]WilliamsMS.Plateleofthecurrentliterature[J].Worldjournalofpsychiatry,2012,2(6):114-123.patientstreatedwithparoxetine:preliminaryfindings[J].Archivesofgeneralpsychiatry,2000,57(9):875-882.cardiovasculardisease[J].Naturecommunications,2017,8(1):845.[19]MohajeriMH,LaFataG,SteinertRE,etal.Relationshipbmicrobiomeandbrainfunction[J].Nutritionreviews,2018,76(7)implicationsforpsychiatry[J].Currentopinioninmetaboliccare,2015,18(6):552-558.[21]PetraAI,PanagiotidouS,HatziagelakiE,etal.GutItsEffectonNeuropsychiatricDisordersWith22]EvrenselA,CeylanME.TheGut-BrainAxis:TheMissingLinkinDepression[J].Clinicalpsychopharmacologyandneuroscience:theofficialscientificjournalof[23]HayleyS,AudetMC,AnismanH.Inflammaimplicationsfordepressivedisorders[J2016,29:42-46.[24]PirbaglouM,KatzJ,deSouzaRJ,etal.Probioaffectanxietyanddepressivesymptocontrolledtrials[J].Nutritionresearch(NewYork,NY),2016,36(9):889-898.[25]WallaceCJK,MilevR.Erratumto:Theeffesymptomsinhumans:asystematicreview[J].Annalsofgeneralpsychiatry,2017,16:18.[26]CarlzonD,SvenssonJ,Petzassociatewithincreasedriskofcardiovasculareventsinelderlymen[J].TheJournalofclinicalendocrinologyandmetabolism,2014,99(11):E2308-2316.medicationusers[J].Psychoneuroendocrinology,2016,68:148-ofcognitivedeclineinnormalageing:Are2018,42:14-27.healthyolderadults[J].Psychoneuroendocrinology,2014,42:118-123.[30]LiuY,WangM,TanX,etal.Negativeco2017,252:111-113.Adults:USPreventiveServicesTaskForceRecommenJama,2016,315(4):380-387.[32]AAFPguidelineforthedetectionandmanagementofpost-myocardial[33]CoventryP,LovellK,DickensC,etal.Integratedprimarycarefmentalandphysicalmultimorbidity:clusterrandomisedcontrolledtrialofcollaborativecareforpatientswicardiovasculardisease[J].BMJ(Clinicalresearched),2015,350.[34]GlassmanAH.Doestreamedicalmortality?[J].Archivesofgeneralpsychiatry,2005,62(7):711-712.[35]GlassmanAH.Cardiovasculareffectsofantidepressantdrugs:updated[J].Internationalclinicalpsychopharmacology,[36]NemeroffCB,SchatzbergAF,GoldsteinDJ,etal.Dofmajordepressivedisorder[J].PsychopharmacolBull,2002 trialsofcoronaryheartdiseasecomplChineseh