艾司西酞普兰对抑郁症患者血清细胞因子水平的影响及疗效观察

目的探讨艾司西酞普兰对抑郁症患者血清细胞因子水平的影响及疗效观察。方法选择80例抑郁症患者,随机分为观察组和对照组,每组各40例。观察组患者予以口服艾司西酞普兰10 mg,起始剂量10 mg/d,早餐后服用,根据病情逐渐调整10～20 mg/d;对照组予以口服舍曲林,起始剂量50 mg/d,早餐后服用,根据病情逐渐调整50～200 mg/d,两组的疗程均为8周。结果治疗8周后,两组患者血清白介素（IL）-2、IL-6和肿瘤坏死因子（TNF）-α水平[（30.47±9.65）、（21.76±5.13）、（26.28±7.42）、（46.41±15.29）、（27.51±5.92）、（35.42±8.12）ng/L]均较治疗前[（59.86±12.27）、（34.42±6.14）、（42.41±8.53）、（60.08±13.02）、（33.92±7.03）、（43.15±9.17）ng/L]明显下降（t=3.47、2.89、2.91、2.32、2.20、2.17,P〈0.01或P〈0.05）,且观察组较对照组下降更明显（t=2.44、2.14、2.25,P〈0.05）;同时观察组临床总有效率（92.5%）明显优于对照组（72.5%）（χ2=5.54,P〈0.05）。对照组和观察组治疗期间出现药物不良反应12例（30.0%）和10例（25.0%）,症状较轻,未发生严重的药物不良反应。两组患者不良反应发生率比较差异无统计学意义（χ2=0.25,P〉0.05）。结论艾司西酞普兰治疗抑郁症疗效确切,能明显改善患者的临床症状,安全性较好,作用机制与其能明显降低血清IL-2、IL-6和TNF-α水平,改善患者的免疫功能密切相关。

Observation on influence and curative effect of Escitalopram Oxalate on serum cytokine levels of depressed disease patients

Objective To discuss the influence and curative effect of Escitalopram Oxalate on serum cytokine levels of depressed disease patients.Methods 80 cases of depress disease patients were selected and divided into observation group and control group at random,with 40 cases in each group.The patients in observation group were given Escitalopram Oxalate（10 mg） by the mouth after breakfast,with 10 mg daily as initial dose,and adjusted gradually from 10 mg to 20 mg daily;the patients in control group were given Sertraline by the mouth,with 50 mg daily initial dose,and adjusted gradually from 50 mg to 200 mg daily.The courses of treatment for the two groups were both 8 weeks.Results After medical treatment for 8 weeks,the serum IL-2 and 6 and TNF-α levels of patients in two groups [（30.47 ±9.65）,（21.76±5.13）,（26.28±7.42）,（46.41±15.29）,（27.51±5.92）,（35.42±8.12） ng/L] declined obviously than before treatment [（59.86 ±12.27）,（34.42 ±6.14）,（42.41±8.53）,（60.08±13.02）,（33.92±7.03）,（43.15±9.17） ng/L]（t = 3.47,2.89,2.91,2.32,2.20,2.17,P〈0.01 or P〈0.05）,and the declining rate in observation group was much higher than that in control group（t = 2.44,2.14,2.25,P〈0.05）.Meanwhile,the total clinical efficiency in observation group（92.5%） was much higher than that in control group（72.5%）（χ^2=5.54,P〈0.05）.The ADR cases appeared in control group and observation group were 12 cases（30.0%） and 10 cases（25.0%） separately with light but not serious symptoms.After compar ing the incidence rates of drug adverse reaction of patients in two groups,the result had no obvious statistical differ ence（χ^2=0.25,P〈0.05）.Conclusion Escitalopram Oxalate has reliable curative effect on depressed disease patients,and can greatly improve the clinical symptom with favorable security,whose mechanism of action has close effect on lowering the serum IL-2 and 6 and TNF-α levels,and improve the immunity function of patients.