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抑郁症可增加冠心病的患病危险及死亡率 ,但迄今为止还没有一种理论可明确阐述这种机制。本文综述抑郁症增加冠心病的发病率及死亡率的可能机制 :下丘脑 -垂体 -肾上腺系统对自主神经功能的改变 ,包括心率 ( HR)增快、心率变异性 ( HRV)降低、压力感受器敏感性 ( BRS)降低 ;中枢神经系统对自主神经功能的改变 ;血小板聚集作用增强 ;炎症反应 ;免疫反应 ;抗抑郁药的心肌毒性及药物间相互作用 ;不良的生活习惯 ;对治疗的依从性差。尽管目前对此机制的研究已有了一些进展 ,但还需要更多和更深入的研究来进一步阐明抑郁症对冠心病的影响。
Depression can increase the risk of coronary heart disease and mortality, but so far there is no one theory can clearly elaborate on this mechanism. This article reviews the possible mechanisms by which depression increases the morbidity and mortality of coronary heart disease: changes of autonomic nervous system in hypothalamus-pituitary-adrenal system including rapid increase of heart rate (HR), decrease of heart rate variability (HRV) and baroreceptor sensitivity (BRS); central nervous system changes in autonomic function; platelet aggregation enhanced; inflammatory response; immune response; anti-depressant cardiotoxicity and drug-drug interactions; poor living habits; poor compliance with treatment. Although some progresses have been made in the research of this mechanism, more and more studies are needed to further elucidate the impact of depression on coronary heart disease.