Schleifer S J, Slater W R, Macari-Hinson M M, Coyle D A, Kahn M, Zucker H D, Gorlin R
Department of Medicine, Mount Sinai School of Medicine City University of New York.
Am Heart J. 1991 May;121(5):1397-402. doi: 10.1016/0002-8703(91)90144-7.
Depression is frequently seen in patients following myocardial infarction (MI), many of whom are receiving digitalis glycosides, beta-blockers, or other agents that may exert central nervous system (CNS) effects. In a prospective study of the clinical significance of post-MI depression, 335 patients were assessed using a standardized diagnostic interview for depression at 8 to 10 days, and 190 were reinterviewed at 3 to 4 months. Patients prescribed digitalis, beta-blockers, or other cardioactive medications at hospital discharge were identified. Logistic regression analyses were performed to determine the contribution of these agents to depression at 3 to 4 months, controlling for medical and sociodemographic factors as well as for baseline depression. Treatment with digitalis predicted depression at 3 to 4 months (p less than 0.05); no other medications, including beta-blockers, predicted depression (p greater than 0.10). Digitalis may have CNS effects that contribute to depression post-MI and this finding should be considered in the differential diagnosis of depression in cardiac patients.
抑郁症在心肌梗死（MI）患者中很常见，其中许多患者正在服用洋地黄苷、β受体阻滞剂或其他可能产生中枢神经系统（CNS）效应的药物。在一项关于心肌梗死后抑郁症临床意义的前瞻性研究中，335例患者在8至10天时使用标准化抑郁诊断访谈进行评估，190例患者在3至4个月时再次接受访谈。确定出院时开具洋地黄、β受体阻滞剂或其他心脏活性药物的患者。进行逻辑回归分析，以确定这些药物在3至4个月时对抑郁症的影响，并控制医学和社会人口学因素以及基线抑郁症。洋地黄治疗可预测3至4个月时的抑郁症（p<0.05）；包括β受体阻滞剂在内的其他药物均未预测到抑郁症（p>0.10）。洋地黄可能具有中枢神经系统效应，导致心肌梗死后抑郁症，这一发现应在心脏病患者抑郁症的鉴别诊断中予以考虑。
