| Background: Unstable angina pectoris is a famiar heart disease ,which has high morbidity and endanger people's health or induce AMI if not cured correctlly.This disease can not only reduce patients' qulity of life ,but also bring severe misery and loss of economy.Depression is another familiar disease in public.it has been noticed that patients sufferring from angina have a high prevalence of depressin disorder,initial studies show that it has high morbidity in patients who are suffuring from angina pectoris and depression make these people have poorer prognosis. Treatment for depression may be a major factor affecting prognosis of these patients,but the effectivness, reliability and influence to prognosis of such patients of antidepressant drugs are not clear until now.Objective:1.To detect further clear and definite morbidity state of depression in patients with unstable angina pectoris. 2.Prospectly investigate relationship of depression to prognosis of unstable angina pectoris including mortality of AMI,morbidity of angina pectoris.3.To study the reliability,effectiveness and the influence on patients' prognosis of antidepressant drugs to such patients.Method:We choose 179 cases unstable angina pectoris patients caused by coronary atherosclerosis ,among them,male 101 cases and female 78 cases, Aged from 43 to 85(average 60.1 +9.6).we also choose33 cases health people suitable in year and sex as matched control.All patients are surveyed using Zung Self-Rate Depression Scale,patients scored below 40 were considered to have no depression and patients scored 40 or higher were considered to have depression;they were designed as no depression group and depression group,there are 111 cases in no depression group and 68 cases in depression group.patients which scored 40 to 48 were considered as mild depression and those which scored 48 or higher are considered as median depression.Depression group is further divided into two groups at random,each has 34 cases, one is drug treatment group,the other is control group.All the patients were given drugs for treatment,such as nitrate,B-receptor blocker, calcium antagonist,anticoagulant, and antiplatelet drugs.At the same time patient in treatment group were given 20mg prozac once every morning and those in control group didn't take any antidepressant. We checked all the patients through blood,urine,liver function,ECG, and .The health group are surveyed using Zung self-Rating Depression Scale after hospitalization.After three months all the patients are follow-uped in order to know occurrence rate of angina pectoris and AMI,and drug treatment compliance,drug ill effect ect.we checked ECG and resurvy all the patients using Zung Self-Rating Depression Scale.All data are expressed as mean ± stardard deviation,the measurement data between two groups are checked by t-test,the enumeration data between groups and the rates between, two samples are checked by chi-square test or Fisher eaxact test,all analysis are performed using SAS software(version 6.12).Results: 1.Patient group's total score is higher than health matched control group's(40.08 ± 15.10,vs30.56 ± 9.26,t=2.728,p<0.05).The depression level of patient group is higher than health matched control group;The incidence rate of depression and median,major depression rateare all higher than that of health matched control group(16.8%,vs 0,x2=8.269,p=0.04). 2.Angina pectoris have occured in 43 of 179 patients,the morbidity is 24.02%, it is higher in Depression group than that in no depression group(32.35%,vsl8.92%,Fisher's exact test,/?=0.0063) . Depression make the morbidity of patients increase two times in the condition of no antidepressant drugs therapy. 3.AMI have occurred in 11 of 179 patients,the occurrence rate is 6.15%; AMI have occurred in 5 patients of no depression group and in 6 patients of depression group , the occurrence rate is seperately 4.5% and 8.82%; AMI have occurred in 3 patients of control group, occurrence rate is 8.82%; occurrence rate of AMI in control group is higher than that in no depression group(x2=3.96 /?=0.038). 4.Scores have no difference between teeatment group and control group before giving drugs,but after 12 weeks scores of treatment group are signifently lower than that of control group(40.27±6.08 vs 47.52 + 7.82,t=4.327/?>0.01);scores of treatment group after treatment is signifently lower than that of pretreatment(40.27 + 6.80 vs 49.56 + 8.16,t=4.833 p>0.01). 5. After 12 weeks the incidence rate of unstable angina pectoris is lower in treatment group than that in control group(29.41% vs 35.29); the incidence rate of AMI in treatment group is equal to that in control group(8.82% vs 8.82%). 6.there was no difference in ST-segment depression's degree between treatment group and control group when hospitalization (2.1 ±1.3 vs 2.2+ 1.3 ,t=4.833 p>2.0). After 12 weeks there was signifently difference in ST-segment depression's degree between treatment group and control group(0.9±0.7 vs 1.3+0.9, p<0.01), there was signifently difference between two groups in number of ST-segment depression(1.7 ± 0.7 vs 2.5+1.2 p=0.048). 7No obvious ill effect of gastrointestinal tract and cardiovascalar system was found among patients in drug treatment group during 12 weeks.Conclusions: 1. The morbidity of depression in this study is 38%, it is high in patients sufferring from unstable angina pectoris and should arouse the attention of clinical doctors. 2. Depression bring negtive effect to unstable angina pectoris,it increase the morbidity of angina pectoris and AMI,it also decrease the life quality and social founction of the patients,it is a important factor for prognosis to patients. 3. Prozac is in a class drugs called selectiveserotomin reuptale inhiibitors(SSRIs),ill effect of cardiovascular system is mild and its reliability is high,it may be used in unstable angina pectoris patients who suffer from depression. 4. Antidepressant can not only decrease the recurrence of unstable angina pectoris and morbidity of AMI,but also modify cardiac ischemia degree and improve patients'life,prognosis and social function.
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