The influence of anti-anxiety and depression treatment on quality life and plasma B-type natriuretic peptide for chronic heart failure patients / 中国医师进修杂志

ABSTRACT

Objective To investigate the influence of anti-anxiety and depression treatment on quality life and plasma B-type natriuretic peptide (BNP) for chronic heart failure (CHF) patients.Methods Eighty-two patients with CHF were divided into control group and intervention group by random digits table method with 41 cases each.After admission,the patients were given conventional anti-heart failure treatment.The patients in intervention group received the standard therapy in combination with lorazepam,with depression plus fluoxetine,and psychological treatment.After treatment,the patients were evaluated by symptom checklist (SCL-90),determined the plasma BNP level and heart function indexes,and recorded the length of stay,number of hospitalization,and so on.Results After treatment the intervention group somatization,interpersonal barriers as well as depression,anxiety,hostility,terrorism,paranoia,psychotic and other emotions significantly alleviated,there were statistical differences compared with before treatment and after treatment of control group (P ＜ 0.05).There were no statistical differences in heart function indexes before treatment between the 2 groups (P ＞ 0.05).After treatment in control group,only the left ventricular ejection fraction was significantly higher than that before treatment,there was statistical difference (P ＜ 0.05).After treatment in intervention group compared with before treatment and after treatment in control group,the heart rate and left ventricular early diastolic and late peak velocity ratio were significantly lower [(71.0 ± 10.9) times/min vs.(82.5 ± 12.4) and (77.3 ± 10.1) times/min,1.26 ± 0.28 vs.1.38 ± 0.21 and 1.31 ± 0.33],left ventricular ejection fraction was significantly higher [(50.9 ± 6.9)％ vs.(39.2 ± 7.4)％ and (43.4 ± 7.8)％],there were statistical differences (P ＜ 0.05).The plasma BNP level was downtrend after treatment in the 2 groups,compared with the control group,after 5 d of treatment in intervention group was significant decrease,the changes was slowly after 14 d of treatment.There were statistical differences in plasma BNP level in 5,7,10 d of treatment between the 2 groups (P ＜ 0.05).The length of stay,number of hospitalization and fatality rate in intervention group were lower than those in control group [(6.0 ± 1.4)d/time vs.(10.0 ± 2.1) d/time,(1.6 ± 0.5) times/year vs.(3.2 ± 0.8) times/years,0 vs.9.8％ (4/41)],there were statistical differences (P ＜ 0.05).Conclusion Anti-anxiety and depression treatment can significantly improve cardiac function in CHF patients,shorter hospital stays,and improve quality of life.