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慢性心力衰竭合并抑郁焦虑：双心医学研究现状
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Abstract:
双心医学称为心理心脏病学或精神心脏病学，是在生理–社会–心理的综合模式下，既注重患者临床生理上的心血管疾病又重视患者精神心理障碍。培养一批既懂心脏又懂心理的“双心”临床医生。心力衰竭是心血管疾病的终末阶段，心力衰竭在心血管疾病中的住院率和死亡率均较高。减少心力衰竭患者的住院率和死亡率是心血管疾病中的重中之重。近年来对抑郁症和CAD的研究兴趣激增，并延续到相关的心血管疾病中。我国大部分双心研究集中在冠心病合并精神心理障碍方面，但对于心力衰竭合并精神心理障碍却很少，心力衰竭近年来已成为抑郁症研究的主要焦点，越来越多的文献表明，具有抑郁症状的HF患者的临床结果较差。本综述主要对于现阶段心力衰竭合并抑郁焦虑的“双心”患者的流行病学特点，发病机制，诊断原则，治疗等进行简要论述。
Psycho-cardiology, also known as psychosomatic cardiology or psychiatric cardiology, is a field that integrates physiological, social, and psychological perspectives. It focuses on patients’ clinical cardiovascular diseases as well as their mental and emotional well-being. The development of a cohort of clinical physicians with expertise in both cardiology and psychology, known as “dual-trained” doctors. Heart failure represents the end stage of cardiovascular diseases, characterized by high rates of hospitalization and mortality. Therefore, reducing the hospitalization and mortality rates among heart failure patients is crucial within the realm of cardiovascular diseases. In recent years, there has been a growing interest in the study of depression and coronary artery disease (CAD), with a focus on their association with related cardiovascular conditions. While the majority of research on psycho-cardiology in China has concentrated on the coexistence of coronary heart disease and psychological disorders, there has been considerably less attention given to heart failure concomitant with psychological disorders. However, heart failure has emerged as a primary focus of depression research in recent years, as an increasing body of literature indicates poorer clinical outcomes in heart failure patients exhibiting depressive symptoms. This review primarily provides a concise discussion of the epidemiological characteristics, pathogenesis, diagnostic principles, and treatment of “dual-trained” patients with heart failure and comorbid depression and anxiety at the present stage.
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