艾司西酞普兰片治疗抑郁症的PSG及BDNF监测分析

目的 考察艾司西酞普兰片治疗对抑郁症患者的多导睡眠图（polysomnogram，PSG）及脑源性神经营养因子（brain-derived neurotrophic factor，BDNF）变化的影响。方法 选择2018年10月-2020年7月60例抑郁症患者，入组第2天开始接受艾司西酞普兰片抗抑郁治疗：每天早餐后服用1次，10 mg·d^-1；2周后统一加量至20 mg·d^-1。观察治疗前后患者的PSG相关指标包括睡眠进程、睡眠结构、快速眼动睡眠阶段（rapid eye movement，REM）睡眠指标，采用ELISA法测定患者治疗前后血清BDNF表达水平。结果 各病例治疗后睡眠潜伏期及其觉醒时间变短、觉醒次数变少、睡眠效率提高，觉睡比升高（P<0.05）；但治疗前后，各病例的总睡眠时间差异不具有统计学意义。睡眠结构指标与治疗前比较，治疗后S1、S2百分比降低（P<0.05），SWS百分比升高（P<0.05）；而REM百分比差异不具有统计学意义。REM睡眠指标与治疗前比较，REM睡眠时间增加、REM睡眠潜伏期降低、REM活动度缩短、REM强度变弱、REM密度减小、REM睡眠出现次数增加（P<0.05）。与治疗前比较，各病例治疗后BDNF平均表达水平升高（P<0.05）。结论 经过艾司西酞普兰片抗抑郁治疗后，患者的睡眠质量改善，且BDNF平均表达水平提升。

Monitoring Analysis of PSG and BNDF in patients with depression treated with escitalopram

OBJECTIVE To investigate the difference of polysomnography(PSG) and brain-derived neurotrophic factors(BNDF) in patients with depression after oral administration of escitalopram. METHODS All of 60 patients with depression from October 2018 to July 2020 were selected and oral administration of escitalopram:the initial was 10 mg·d^-1, and was gradually increased to 20 mg·d^-1 on the 14th day. Their sleep process, sleep structure and rapid eye movement(REM) sleep indicators were investigated before and after treatment. Serum BDNF level was measured by ELISA before and after the treatment. RESULTS Compared with before treatment, after treatment, sleep latency, wake time and wake times were decreased, sleep efficiency was improved, and sleep ratio was increased(P<0.05), while the difference in total sleep time was not statistically significant. Compared with before treatment, after treatment, the percentages of S1 and S2 were significantly decreased(P<0.05); the percentage of SWS was significantly increased(P<0.05); while the REM ratio was not statistically significant. After the treatment, various REM indicators were significantly changed in patients with depression, appearing longer REM sleep time, shortened REM latency, decreased REM activity, REM intensity, REM density and larger number of REM sleep(P<0.05). Compared with before treatment, BDNF average level was significantly increased after treatment(P<0.05). CONCLUSION After oral administration of escitalopram combined with hypnotic, the sleep quality of patients is significantly improved, and the level of BDNF elevated.