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目的探讨慢性缺血性心力衰竭伴发抑郁障碍患者血管内皮功能的状态。方法对56例临床症状稳定的慢性缺血性心力衰竭患者Zung抑郁自评量表(SDS)进行抑郁障碍评估,根据SDS标准分分为抑郁障碍组(n=20)、非抑郁障碍组(n=36),分别用超声检测肱动脉血流介导的血管舒张(FMD),同时检测血浆NO、ET-1水平,比较两组之间血管内皮功能的差异。结果 56例慢性缺血性心衰患者中抑郁障碍发生率35.7%;抑郁障碍组FMD参数即反应性充血后肱动脉内径变化率[(5.97±0.78)%]、血浆NO水平[(48.90±9.82)μmol/L]低于非抑郁障碍组[(6.66±0.83)%、(55.13±10.32)μmol/L,均P<0.05],血浆ET-1水平[(83.35±13.39)ng/L]高于非抑郁障碍组[(74.67±10.95)ng/L,P<0.05]。结论慢性缺血性心力衰竭伴抑郁障碍者血管内皮功能受损程度较非抑郁障碍者更为严重。
Objective To investigate the status of vascular endothelial function in patients with chronic ischemic heart failure and depressive disorder. Methods Depression disorders were evaluated in 56 patients with stable clinical symptoms of chronic ischemic heart failure (SDS), and were divided into depression group (n = 20), non-depression group (n = 36). The brachial artery blood flow-mediated vasodilatation (FMD) was detected by ultrasound. The levels of NO and ET-1 in plasma were measured at the same time. The differences of vascular endothelial function between the two groups were compared. Results The incidence of depressive disorder in 56 patients with chronic ischemic heart failure was 35.7%. The changes of the FMD parameters in the depressive disorder group, ie, the change rate of brachial artery diameter after reactive hyperemia (5.97 ± 0.78)% and plasma NO level (48.90 ± 9.82 ) (μmol / L) were significantly lower than those in nondepressive group [(6.66 ± 0.83)% vs (55.13 ± 10.32) μmol / L, all P <0.05] and plasma ET-1 levels (83.35 ± 13.39) ng / L In the group of non-depressive disorder [(74.67 ± 10.95) ng / L, P <0.05]. Conclusion The severity of vascular endothelial dysfunction in patients with chronic ischemic heart failure and depressive disorder is more serious than those without depressive disorder.