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[1]卓兴峰,钟勇,宫剑滨,等.不同降压方案对高血压患者心理评分的影响[J].医学研究与战创伤救治(原医学研究生学报),2023,25(1):54-57.[doi:10.3969/j.issn.1672-271X.2023.01.011]
　ZHUO Xingfeng,ZHONG Yong,GONG Jianbin,et al.Influence of different antihypertensive programs on psychological score of patients with hypertension[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2023,25(1):54-57.[doi:10.3969/j.issn.1672-271X.2023.01.011]
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不同降压方案对高血压患者心理评分的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第25卷
期数:
2023年1期
页码:
54-57
栏目:
临床研究
出版日期:
2023-05-10

文章信息/Info

Title:
Influence of different antihypertensive programs on psychological score of patients with hypertension
作者:
卓兴峰; 钟勇; 宫剑滨; 庄微; 苑小厉; 刘斌
作者单位：210002南京，南京大学医学院附属金陵医院（东部战区总医院）特约门诊（卓兴峰、钟勇、宫剑滨、庄微、苑小厉、刘斌）
Author(s):
ZHUO Xingfeng;  ZHONG Yong;  GONG Jianbin;  ZHUANG Wei;  YUAN Xiaoli; LIU Bin
（Department of Vip Clinic，Jinling Hospital，Affiliated Hospital of Medical School,Nanjing University/General Hospital of Eastern Theater Command，PLA，Nanjing 210002，Jiangsu，China）
关键词:
高血压; 心理测评; 焦虑; 抑郁; β受体阻滞剂
Keywords:
high blood pressure;  psychological evaluation;  anxiety;  depression;  calcium channel blockers;  β receptor blocker
分类号:
R544.1R587.1
DOI:
10.3969/j.issn.1672-271X.2023.01.011
文献标志码:
A
摘要:
目的通过对应用包括β受体阻滞剂与不包括β受体阻滞剂的两种不同降压治疗方案的高血压患者进行专业的心理测评，评估降压药在心理方面作用。方法选择2018年10月-2021年6月南京大学医学院附属金陵医院门诊174例高血压患者。按随机数字表法分为β受体阻滞剂组（β组）和非β组。β组（83例）包括钙通道阻滞剂（CCB）联合美托洛尔44例及CCB联合比索洛尔39例；非β组（91例）包括CCB联合血管紧张素Ⅱ受体拮抗剂（ARB）57例、CCB联合血管紧张素转换酶抑制剂（ACEI）23例及单用CCB 11例。2组均采用焦虑自评测试（SAS）和抑郁自评测试（SDS），并由专业的心理医师对2组患者进行心理测评。结果抑郁比较：β组的抑郁发生率、总体抑郁评分、男性抑郁评分、女性抑郁评分、≤60岁患者抑郁评分及＞60岁患者抑郁评分均明显高于非β组，分别为（22.89% vs 8.79%，P＜0.05）、（41.54±12.00 vs 33.70±8.72，P＜0.01）、（38.48±11.82 vs 32.15±7.98，P＜0.01）、（48.64±9.22 vs 37.03±9.43，P＜0.01）、（40.51±11.70 vs 34.10±9.23，P＜0.01）及（42.55±12.35 vs 33.20±8.12，P＜0.01）。β组与非β组的组内抑郁评分女性均明显高于男性，分别为（48.64±9.22 vs 38.48±11.82，P＜0.01）及（37.03±9.43 vs 32.15±7.98，P＜0.05）；≤60岁与＞60岁则差异无统计学意义，分别为（40.51±11.70 vs 42.55±12.35，P＞0.05）及（34.10±9.23 vs 33.20±8.12，P＞0.05）。焦虑比较：β组的焦虑发生率、总体焦虑评分、男性焦虑评分、女性焦虑评分、≤60岁患者焦虑评分及＞60岁患者焦虑评分均明显高于非β组，分别为（26.51% vs 10.99%，P＜0.05）、（41.34±11.64 vs 34.87±9.13，P＜0.01）、（39.09±11.49 vs 33.35±8.72，P＜0.01）、（46.56±10.41 vs 38.10±9.29，P＜0.01）、（41.54±11.58 vs 35.18±9.07，P＜0.01）及（41.14±11.83 vs 34.48±9.30，P＜0.01）。β组与非β组的组内焦虑评分女性明显高于男性，分别为（46.56±10.41 vs 39.09±11.49，P＜0.01）及（38.10±9.29 vs 33.35±8.72，P＜0.05）；≤60岁与＞60岁则差异无统计学意义，分别为（41.54±11.58 vs 41.14±11.83，P＞0.05）及（35.18±9.07 vs 34.48±9.30，P＞0.05）。结论高血压病治疗过程中，β受体阻滞剂可能会增加抑郁和焦虑的发生，女性高血压患者则有更高的抑郁与焦虑倾向。因此，对于有抑郁或焦虑倾向的高血压患者，降压药物的选择上应慎用β受体阻滞剂。
Abstract:
ObjectiveTo evaluate the psychologicaleffects of antihypertensive drugs in patients with hypertension who were treated with or without β receptor blockers.MethodsA total of 174 hypertensive patients were recruited from the outpatient department of Affiliated Jinling Hospital, Medical School of Nanjing University from October 2018 to June 2021. The patients were randomly divided into β receptor blocker group（β Group) and non-β Group. β group (83 cases) included calcium channel blocker (CCB) combined with metoprolol (44 cases) and CCB combined with bisoprolol (39 cases). Non-β group (91 cases) included CCB combined with ARB (57 cases), CCB combined with ACEI (23 cases) and CCB alone (11 cases). All patients were psychologically evaluated by professional psychiatrists.ResultsDepression comparison: The incidence of depression, overall depression score, male depression score, female depression score, depression score of ≤60 years old patients and > 60 years old patients in β group were significantly higher than those in non-β group (22.89% vs 8.79%, P<0.05), (41.54±12.00 vs 33.70±8.72, respectively). P<0.01), (38.48±11.82 vs 32.15±7.98, P<0.01), (48.64±9.22 vs 37.03±9.43, P<0.01), (40.51±11.70 vs 34.10±9.23, P<0.01) and (42.55±12.35 vs 33.20±8.12, P<0.01). The depression scores in β and non-β groups were significantly higher in females than that in males (48.64±9.22 vs 38.48±11.82, P<0.01) and (37.03±9.43 vs 32.15±7.98, P<0.05), respectively. There was no significant difference between ≤60 years old and > 60 years old (40.51±11.70 vs42.55±12.35, P>0.05) and (34.10±9.23 vs 33.20±8.12, P>0.05), respectively. Comparison of anxiety: The incidence of anxiety, overall anxiety score, male anxiety score, female anxiety score, anxiety score of ≤60 years old patients and anxiety score of > 60 years old patients in β group were significantly higher than those in non-β group (26.51% vs 10.99%, P<0.05), (41.34±11.64 vs 34.87±9.13, P<0.01), (39.09±11.49 vs 33.35±8.72, P<0.01), (46.56±10.41 vs 38.10±9.29, P<0.01), (41.54±11.58 vs 35.18±9.07, P<0.01) and (41.14±11.83 vs 34.48±9.30, P<0.01). β and non-β anxiety scores were significantly higher in females than that in males (46.56±10.41 vs 39.09±11.49, P<0.01) and (38.10±9.29 vs 33.35±8.72, P<0.05), respectively. There was no significant difference between ≤60 years old and > 60 years old (41.54±11.58 vs 41.14±11.83, P>0.05) and (35.18±9.07 vs 34.48±9.30, P>0.05), respectively.ConclusionDuring the treatment of hypertension, β receptor blockers may increase the incidence of depression and anxiety, and female patients with hypertension are more prone to depression and anxiety. Therefore, β receptor blockers should be carefully used in the selection of antihypertensive drugs for hypertensive patients with depression or anxiety tendency.

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更新日期/Last Update: 2023-04-19