【《抑郁與冠心病的研究進(jìn)展綜述論文》4200字】

1 2 2 2 3 3 3 4 4 5 參考文獻(xiàn) 6發(fā)病機(jī)制、早期篩查、治療方案等幾個方面進(jìn)行綜述。關(guān)鍵詞：冠心病、抑郁、機(jī)制、治療抑郁是冠心病(Coronaryheartdisease,CHD)發(fā)生、發(fā)展的獨(dú)立危險(xiǎn)因素，在CHD患者中高發(fā)。有研究表明，每5名CHD患者中就有1人患有抑郁癥，其抑郁共病的現(xiàn)象越來越受到臨床醫(yī)師的關(guān)注。新診斷的CHD患者若合并重度抑郁癥，其心血管不良事件的風(fēng)險(xiǎn)在12個月內(nèi)會增加一倍3。先前的研究也顯示，CHD患者抑郁癥狀與心臟事件之間存在劑量-反應(yīng)關(guān)系，即使抑郁癥癥狀的輕微增加，也AMI入院患者長達(dá)12個月的隨訪研究顯示，260名抑郁癥患者的直接醫(yī)療費(fèi)用比非抑郁癥患者高41%,原因是門診費(fèi)用增加，急診就診次數(shù)增多，心源性再入院時間延長。在654名疑似CHD的女性中，輕度至中度抑郁癥患者的總體心血管治療費(fèi)用比對照組高33%,單藥物治療費(fèi)用就比對組高21%。而總社會成2.CHD患者合并抑郁的可能發(fā)病機(jī)制心率變異性(Heartratevariability,HRV)的降低與該調(diào)節(jié)功能受損有關(guān)。而心率增快與HRV的降低均可誘發(fā)心源性猝死1。2.4下丘腦-垂體-腎上腺軸激活、炎癥和氧化應(yīng)激2.5內(nèi)皮功能損傷和血小板激活減弱7。2.6腸道微生物群2.7內(nèi)分泌機(jī)制3.CHD患者合并抑郁的早期篩查4.CHD患者合并抑郁的治療CHD患者合并抑郁的藥物治療可以有效緩解其抑郁情緒33,但無法減輕抑郁發(fā)生、發(fā)展，但其相關(guān)機(jī)制仍需進(jìn)一步的基礎(chǔ)實(shí)驗(yàn)前中藥聯(lián)合抗抑郁藥物治療并未在臨床上較大范圍應(yīng)用，相關(guān)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]李愛民.冠心病患者心理抑郁的相關(guān)研究進(jìn)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