Clinical Research Of New-generation Antidepressants And Amitriptyline In Treatment Of Depression Patients With Coronary Heart Disease

Background With the social and economic development,living standards and the level of medical care have been improved,the population has gradually entered the aging society,social competence and living pressure increase year by year,with the exception of psychosocial factors and adverse effect of lifestyle behaviors,the prevalence of coronary heart disease(CHD)and depression is rising,which has become two major disease impacting on human health.There may be common mechanisms of CHD and depression,cardiovascular physicians should give the foundation heart disease drug treatment assisting antidepressant treatment for patients with CHD complicated depression in clinical practice,so as to reduce the incidence of cardiovascular events and improve the quality of life and prognosis.Objectives1.To observe the clinical efficacy of the foundation heart disease drug treatment assisting antidepressant treatment in depression with CHD.2.To evaluate the safety of different antidepressants in the treatment of depression patients with CHD.Methods1.270 cases of episode depressive patients with CHD were performed from October of 2013 to October of 2015 in the Second Affiliated Hospital of Xinxiang Medical University,All patients were given based anti-heart disease drugs and were randomly divided into a control group of 50 cases,Amitriptyline group of 50 cases,Venlafaxine group of 50 cases,Mirtazapine group of 50 cases,Escitalopram group of 70 cases.2.To observe the clinical efficacy after antidepressant treatment of 6 weeks as follows:the number of cases of angina pectoris,ST segment depression improvement,the improvement of depressive symptoms according to Hamilton Depression Scale(HAMD).3.To observe the safety of new antidepressant drug,We monitored the blood,liver function,blood lipids,blood glucose after treatment of 2 weeks,4 weeks,6 weeks,and comparing with before treatment.Results1.The safety analysis of new antidepressant drug: The level of WBC and NE# of patients in Amitriptyline group was markedly lower after 6 weeks than that before treatment(P<0.05),but the level of ALT,AST,T-CHO,GLU was markedly higher(P<0.05).The level of NE#,WBC,GLU of patients in Venlafaxine group was markedly lower after 6 weeks than that before treatment(P<0.05).After six-week treatment,ALT,AST,LDL in Mirtazapine group was significantly higher than that before treatment(P<0.05).In Escitalopram group,TG was seen higher after six-week treatment(P<0.05).AST changes in the Venlafaxine group and Mirtazapine group showed significant difference after treatment(P<0.05).WBC changes in the Amitriptyline group and Mirtazapine group after six-week treatment showed significant difference(P<0.05).NE#changes in the Amitriptyline group was significantly higher than Mirtazapine group and Escitalopram group(P<0.05).AST changes in the Amitriptyline group and Venlafaxine group showed significant difference(P<0.05).2.The evaluation of antidepressant drugs on clinical efficacy in CHD complicated with depression: after based anti-heart disease drugs assisting antidepressant treatment in CHD complicated with depression,HAMD scores is better than before treatment,venlafaxine group,mirtazapine,escitalopram group showed significant difference compared with control group(P<0.05),escitalopram group showed significant difference compared with amitriptyline group(P<0.05).The incidence of cardiovascular events in the treatment group was lower than the control group,there was a statistical significance within the two groups(P<0.05).the improvement of ST segment depression was different within the two groups,the difference had statistical significance(P<0.05).Conclusions1.The clinical efficacy of the based anti-heart disease drugs assisting antidepressant treatment is better than single basic treatment on depression patients with coronary heart disease.2.Three different kinds of new-generation antidepressants have fewer influence on blood,liver function,blood lipids,and blood glucose than Amitriptyline in the treatment of depression patients with CHD.But new-generation antidepressants also have some negative impact on blood,liver function,blood lipids and blood glucose,which need to be monitored,in order to prevent the occurrence of adverse reactions.