The effect of Xinkeshu tablets on depression and anxiety symptoms in patients with coronary artery disease: Results from a double-blind, randomized, placebo-controlled study
The effect of Xinkeshu tablets on depression and anxiety symptoms in patients with coronary artery disease: Results from a double-blind, randomized, placebo-controlled study
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心可舒片对冠心病患者抑郁和焦虑症状的影响：双盲、随机、安慰剂对照研究的结果
DOI：
10.1016/j.biopha.2019.108639
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发表时间：
2019-04-01
影响因子：
7.5
通讯作者：
Zhang, Minzhou
中科院分区：
文献类型：
--
作者：
Ma, Huan;Wang, Yu;Zhang, Minzhou
大部分冠状动脉疾病（CAD）患者患有抑郁或焦虑症状，这与死亡率增加有关[1]。这项双盲、随机、安慰剂对照的临床试验（ChiCTR-IPR-17010940）旨在探索心可舒片是否可以减轻CAD患者的焦虑或抑郁症状，以及这与血浆细胞因子浓度的关系。对60例住院焦虑抑郁量表（HADS-a/HADS-d）评分≥ 8分的冠心病患者，在经皮血运重建术后给予心可舒片或安慰剂治疗12周。在基线和治疗12周后评估抑郁/焦虑症状和440种外周血细胞因子水平。结果显示心可舒片治疗组HADS-a/HADS-d及PHQ-9评分明显低于安慰剂组（P < 0.05）。这些改善与某些外周血细胞因子的变化有关;最显著的是trappin-2、脂联素、白细胞介素1 β（IL-1 β）、血小板生成素、活化白细胞粘附分子（ALCAM）、神经营养素-3（NT-3）和转铁蛋白。在CAD患者的独立队列中观察到焦虑/抑郁症状与trappin-2、NT-3、转铁蛋白和ALCAM之间的显著相关性（p < 0.05）。这些结果与心可舒片的抗抑郁作用相一致。本试验表明，心可舒片可能通过提高血中抗炎：促炎细胞因子的比值，有效改善冠心病患者的焦虑抑郁症状。
A large proportion of patients with coronary artery disease (CAD) suffer from depression or anxiety symptoms and this is associated with increased mortality [1]. This double-blinded, randomized, placebo-controlled, clinical trial (ChiCTR-IPR-17010940) aimed to explore whether Xinkeshu tablets can reduce anxiety or depressive symptoms in CAD patients and how this is related to the concentration of plasma cytokines. Sixty patients with CAD and a Hospital Anxiety and Depression Scale (HADS-a/HADS-d) score of >= 8 were treated with Xinkeshu tablets or placebo for 12 weeks following percutaneous revascularization. Depressive/anxiety symptoms and the levels of 440 peripheral blood cytokines were evaluated at baseline and after 12 weeks treatment. Results showed significantly lower (P < 0.05) HADS-a/HADS-d and PHQ-9 scores in CAD patients treated with Xinkeshu tablets than in those who received placebo. These improvements were associated with changes in certain peripheral blood cytokines; most notably trappin-2, adiponectin, interleukin 1 beta (IL-1 beta), thrombopoietin, activated leukocyte cell adhesion molecule (ALCAM), neurotrophin-3 (NT-3), and transferrin. A significant correlation between anxiety/depression symptoms and trappin-2, NT-3, transferrin, and ALCAM (p < 0.05) were observed in an independent cohort of patients with CAD. These findings were in-keeping with the antidepressive effects of Xinkeshu tablets. This trial demonstrates that Xinkeshu tablets can improve anxiety and depression symtoms effectively address in patients with coronary heart disease possibly through increasing the blood ratio of anti-inflammatory: pro-inflammatory cytokines.