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JAMA Inter Med：急性冠心病患者筛查抑郁没用?

2019-10-24 朱朱 中国循环杂志

急性冠心病抑郁症筛查
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近日发表在JAMA内科学子刊上的一项随机对照研究结果却表明，在没有抑郁症病史的急性冠脉综合征患者中，系统筛查抑郁症并不会改善患者的预后。

2014年，美国心脏协会发表科学声明称，抑郁症与肥胖、糖尿病、高血压、吸烟一样，也是心脏病的危险因素。
 
据报道，大约20%的急性冠脉综合征患者达到了重度抑郁的临床标准，有抑郁症状的患者则更多。
 
有抑郁症状的急性冠脉综合征患者容易复发心血管事件，死亡风险也较高，生活质量较差。因此，有专家建议急性冠脉综合征患者进行抑郁症筛查。
 
但是，近日发表在JAMA内科学子刊上的一项随机对照研究结果却表明，在没有抑郁症病史的急性冠脉综合征患者中，系统筛查抑郁症并不会改善患者的预后。
 
研究显示，经筛查，7.1%的急性冠脉综合征患者存在抑郁症状。
 
与没有进行抑郁症筛查的患者相比，接受郁郁症筛查的患者在查出有抑郁症状后不论是否给予相应治疗，质量调整寿命年、免受抑郁症困扰的时间均没有变化，死亡、出血或睡眠困难等事件也没有减少或增多。
 
该研究共纳入1500例急性冠脉综合征患者，其平均年龄为65.9岁，以1:1:1的比例随机分入三组：（1）系统筛查抑郁症，如有抑郁症状，通知患者并给予抑郁症治疗；（2）系统筛查抑郁症，如有抑郁症状，通知患者但不给予相应治疗；（3）不筛查抑郁症；共随访18个月。
 
这些患者在入选前2~12个月内因急性冠脉综合征住院，既往无抑郁症病史。

原始出处：

Kronish IM1, Moise N1, Cheung YK2, et al. Effect of Depression Screening After Acute Coronary Syndromes on Quality of Life: The CODIACS-QoL Randomized Clinical Trial. JAMA Inter Med. Published online October 21, 2019.

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    2020-01-20 智者为医08

    #急性冠心病#

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    2019-10-25 liubm557

    #冠心病患者#

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    2019-10-25 ms3994565386320060

    #Med#

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    2019-10-25 147612bem32暂无昵称

    牛逼

    0