阿米替林与帕罗西汀治疗抑郁综合征临床疗效评价

抑郁综合征是临床上一种常见精神疾病,复发率较高,严重者可出现自杀念头和行为。临床症状主要表现为持续性情绪低落、兴趣减低、悲观、思维迟缓[1]。临床治疗中,采用传统三环类抗抑郁药阿米替林和新型5-HT再摄取抑制剂帕罗西汀进行治疗,两种给药各有优势,为此我院将进一     

帕罗西汀与阿米替林治疗帕金森病并发抑郁症状对照研究

目的 比较帕罗西汀与阿米替林治疗帕金森病伴发抑郁的疗效及不良反应.方法 48例帕金森病伴发抑郁（帕金森病伴发抑郁）患者被随机分为帕罗西汀组（24例）和阿米替林组（24例）,进行为期6周的治疗观察,以汉密尔顿抑郁量表（HAMD）、不良反应量表（TESS）于治疗前及疗后1、2、4、6周末分别评定疗效及不良反应并进行统计学处理.结果 帕罗西汀组显效率为83 .3%,阿米替林组显效率为79.2%,两组显效率比较无显著性差异（P＜0.05）.两组HAMD评分治疗后与治疗前比较均呈非常显著性下降（P＜0.001）,两组间比较无显著性差异（P＞0.05）.帕罗西汀组不良作用的发生率及种类明显低于阿米替林组.结论 提示帕罗西汀与阿米替林对卒中后抑郁均有良好疗效.帕罗西汀具有不良反应小,治疗依从性较好等特点,是治疗帕金森病伴发抑郁的理想药物.     

血清脑源性神经营养因子在脑卒中后抑郁症中的意义

脑卒中后抑郁（post stroke depression,PSD）是脑卒中后常见并发症之一,严重影响患者的的神经、社会康复和生活质量[1].我国35%~70%的脑卒中患者并发抑郁[2],但脑卒中后抑郁的发病机制仍不十分清楚.脑源性神经营养因子（BDNF）在脑内含量丰富,具有重要的生理功能[3],国内外研究显示BDNF参与了抑郁症的发病[4-5].本课题组研究显示卒中后抑郁与BDNF具有相关性,现报告如下.     

脑卒中后抑郁与脑源性神经营养因子基因Val66Met单核苷酸多态性的相关性研究

目的探讨脑卒中后抑郁(PSD)与脑源性神经营养因子(BDNF)基因Val66Met单核苷酸多态性(SNP)的相互关系。方法选择86例PSD患者为PSD组,68例脑卒中无PSD患者为无PSD组,另选择46名健康者为对照组。3组研究对象年龄及性别基本匹配。采用酶联免疫吸附法检测BDNF浓度和等位基因特异性聚合酶链反应(A-S PCR)技术检测BDNF基因Val66Met位点SNP的分布。结果 PSD组和无PSD组间BDNF表达差异有统计学意义(t=-2.038,P=0.043);两组间基因型频率(χ2=0.340,P=0.844)和等位基因频率(χ2=0.036,P=0.849)差异均无统计学意义。结论 BDNF表达与PSD发生相关,但BDNF基因Val66Met位点SNP与PSD未发现有相关关系。     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

目的 探讨脑源性神经营养因子(BDNF)在抑郁发作自杀未遂者中的可能作用.方法 对抑郁发作自杀未遂患者(自杀未遂组,23例)和抑郁发作无自杀行为患者(无自杀组,24例)采用汉密尔顿抑郁量表(24项,HAMD24)、Beck绝望量表(BHS)和自杀意念自评量表(SIOSS)评定抑郁严重程度、绝望程度及自杀意图的强烈程度;采用酶联免疫吸附法测定其血清BDNF浓度,并与正常对照者(对照组,30名)比较;对自杀未遂组的血清BDNF浓度与各相关因素进行Pearson相关分析.结果 (1)自杀未遂组的HAMD24[(37.8±8.7)分]、BHS[(13.0±3.8)分]及SIOSS评分[(18.1±3.9)分]均高于无自杀组[分别为(26.0±6.0)分、(7.5±4.3)分、(12.0±4.0)分;P<0.01].(2)自杀未遂组的BDNF平均浓度[(57 ±16)ng/L]低于无自杀组[(75 ±28)ng/L;P<0.05],无自杀组的BDNF平均浓度亦低于正常对照组[(111±39)ng/L;P<0.01].(3)自杀未遂组的血清BDNF浓度与抑郁发作的病程(r=-0.541)、BHS总分(r=-0.494)、SIOSS总分(r=-0.754)呈负相关(P<0.01-0.05).结论 低水平的BDNF可能是抑郁发作自杀未遂的一个危险因素.     

度洛西汀与阿米替林治疗脑卒中后抑郁对照研究

目的比较度洛西汀与阿米替林治疗脑卒中后抑郁的临床疗效。方法对90例脑卒中后抑郁住院患者随机分为2组,度洛西汀组和阿米替林组各45例,治疗8周,采用汉密尔顿抑郁量表评定临床疗效。结果度洛西汀组和阿米替林组有效率分别为88.89%和86.67%,2组间疗效差异无统计学意义(P>0.05)。结论度洛西汀和阿米替林对脑卒中后抑郁疗效相当,值得临床推广。     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

Objective To investigate the possible role of brain-derived neurotrophic factor(BDNF)in the pathophysiology of attempted suicide in depressive episode patients.Methods The subjects were 23 depressive episode patients who had recently attempted suicide.24 depressive episode patients without suicide attempt.and 30 sex-age-and education matched healthy controls.The Hamihon Depression Rating Scale-24 items(HAMD24),Beck Helpless Rating Scale(BHS)and Self-rating Idea of Suicide Scale (SIOSS)was used to evaluate the severitv of symptoms.The seruln level of BDNF was detected with sandwich ELISA.Pearson correlation coefficients wag used to measure the correlations between serum BDNF and the related illness variables.Results There were significant difierences in the serum level of BDNF between patients with attempted suicide,pailents without suicide attempt and normal controls(F=21.927,P＜0.05).Post hoc analysis showed the serum BDNF levels in patients with attempted suicide [(57 ±16)ng/L]were lower than that in patients without[(75±28)ns/L;P＜0.05],and were lower in patients without suicide attempt[(75 ±28)ng/L]than that in normal controls[(111 ±39)ng/L;P＜0.01].In patients with attempted suicide,the serum BDNF was negatively correlated to the duration of depressive episode(r=-0.541,P=0.008),the mean BHS score(r=-0.494,P=0.017)and the mean SIOSSscore(r=-0.754.P=0.000).Conclusion The results suggest that the decreased serum brain-derived neurotrophic factor is related to the pathophysiology of attempted suicide in depressive episode patients.     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

Objective To investigate the possible role of brain-derived neurotrophic factor(BDNF)in the pathophysiology of attempted suicide in depressive episode patients.Methods The subjects were 23 depressive episode patients who had recently attempted suicide.24 depressive episode patients without suicide attempt.and 30 sex-age-and education matched healthy controls.The Hamihon Depression Rating Scale-24 items(HAMD24),Beck Helpless Rating Scale(BHS)and Self-rating Idea of Suicide Scale (SIOSS)was used to evaluate the severitv of symptoms.The seruln level of BDNF was detected with sandwich ELISA.Pearson correlation coefficients wag used to measure the correlations between serum BDNF and the related illness variables.Results There were significant difierences in the serum level of BDNF between patients with attempted suicide,pailents without suicide attempt and normal controls(F=21.927,P＜0.05).Post hoc analysis showed the serum BDNF levels in patients with attempted suicide [(57 ±16)ng/L]were lower than that in patients without[(75±28)ns/L;P＜0.05],and were lower in patients without suicide attempt[(75 ±28)ng/L]than that in normal controls[(111 ±39)ng/L;P＜0.01].In patients with attempted suicide,the serum BDNF was negatively correlated to the duration of depressive episode(r=-0.541,P=0.008),the mean BHS score(r=-0.494,P=0.017)and the mean SIOSSscore(r=-0.754.P=0.000).Conclusion The results suggest that the decreased serum brain-derived neurotrophic factor is related to the pathophysiology of attempted suicide in depressive episode patients.     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

Objective To investigate the possible role of brain-derived neurotrophic factor(BDNF)in the pathophysiology of attempted suicide in depressive episode patients.Methods The subjects were 23 depressive episode patients who had recently attempted suicide.24 depressive episode patients without suicide attempt.and 30 sex-age-and education matched healthy controls.The Hamihon Depression Rating Scale-24 items(HAMD24),Beck Helpless Rating Scale(BHS)and Self-rating Idea of Suicide Scale (SIOSS)was used to evaluate the severitv of symptoms.The seruln level of BDNF was detected with sandwich ELISA.Pearson correlation coefficients wag used to measure the correlations between serum BDNF and the related illness variables.Results There were significant difierences in the serum level of BDNF between patients with attempted suicide,pailents without suicide attempt and normal controls(F=21.927,P＜0.05).Post hoc analysis showed the serum BDNF levels in patients with attempted suicide [(57 ±16)ng/L]were lower than that in patients without[(75±28)ns/L;P＜0.05],and were lower in patients without suicide attempt[(75 ±28)ng/L]than that in normal controls[(111 ±39)ng/L;P＜0.01].In patients with attempted suicide,the serum BDNF was negatively correlated to the duration of depressive episode(r=-0.541,P=0.008),the mean BHS score(r=-0.494,P=0.017)and the mean SIOSSscore(r=-0.754.P=0.000).Conclusion The results suggest that the decreased serum brain-derived neurotrophic factor is related to the pathophysiology of attempted suicide in depressive episode patients.     

抑郁发作自杀未遂患者脑源性神经营养因子水平及其相关因素研究

Objective To investigate the possible role of brain-derived neurotrophic factor(BDNF)in the pathophysiology of attempted suicide in depressive episode patients.Methods The subjects were 23 depressive episode patients who had recently attempted suicide.24 depressive episode patients without suicide attempt.and 30 sex-age-and education matched healthy controls.The Hamihon Depression Rating Scale-24 items(HAMD24),Beck Helpless Rating Scale(BHS)and Self-rating Idea of Suicide Scale (SIOSS)was used to evaluate the severitv of symptoms.The seruln level of BDNF was detected with sandwich ELISA.Pearson correlation coefficients wag used to measure the correlations between serum BDNF and the related illness variables.Results There were significant difierences in the serum level of BDNF between patients with attempted suicide,pailents without suicide attempt and normal controls(F=21.927,P＜0.05).Post hoc analysis showed the serum BDNF levels in patients with attempted suicide [(57 ±16)ng/L]were lower than that in patients without[(75±28)ns/L;P＜0.05],and were lower in patients without suicide attempt[(75 ±28)ng/L]than that in normal controls[(111 ±39)ng/L;P＜0.01].In patients with attempted suicide,the serum BDNF was negatively correlated to the duration of depressive episode(r=-0.541,P=0.008),the mean BHS score(r=-0.494,P=0.017)and the mean SIOSSscore(r=-0.754.P=0.000).Conclusion The results suggest that the decreased serum brain-derived neurotrophic factor is related to the pathophysiology of attempted suicide in depressive episode patients.     

脑卒中后抑郁的相关因素和帕罗西汀治疗研究

目的 探讨脑卒中后抑郁的发生率、相关因素及治疗方法。方法 对368例脑卒中进行脑卒中亚型分类、神经功能缺损程度（SSS）、汉密尔顿抑郡量表（HAMD）评分：将其中并发脑卒中后抑郁（PSD）的148例随机分为治疗组74例和对照组74例，治疗4周，治疗后进行SSS、HAMD评分并比较。结果 脑卒中后抑郁的发生与脑卒中亚型无关。与神经功能缺损程度密切相关；帕罗西汀治疗组抑郁和神经功能改善均优于对照组。结论 脑卒中后抑郁的发生是多因素的，5-羟色胺再摄取抑制剂帕罗西汀治疗可明显改善脑卒中后抑郁及其神经功能。     

帕罗西汀联合心理治疗对卒中后抑郁的疗效

目的评价帕罗西汀联合心理治疗对脑卒中后抑郁的疗效。方法将符合CCMD-3诊断标准的68例脑卒中后抑郁患者,随机分为联合治疗组和帕罗西汀组,疗程8周,以汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、日常生活能力量表(ADL)、治疗时出现的反应量表(TESS)为评定工具。随访半年后进行临床疗效及日常生活能力评定。结果治疗后6、8周末两组HAMD、HAMA评分有显著性差异(p<0.05)。随访半年后联合治疗组的显效率为79.41%,帕罗西汀组为52.95%,两组相比有显著性差异(p<0.05)。结论帕罗西汀联合心理治疗对卒中后抑郁疗效好,并且持久。     

帕罗西汀治疗脑卒中后抑郁障碍的临床疗效

目的：探讨脑卒中后抑郁障碍患者接受帕罗西汀治疗的临床效果。方法脑卒中后抑郁障碍患者126例随机分为治疗组和对照组各63例,对照组给予脑卒中常规药物治疗,治疗组在对照组的基础上给予帕罗西汀治疗。比较2组治疗前、治疗2周、4周、8周后的汉密尔顿抑郁量表（HAMD）评分,以及治疗前后日常生活能力Barthel指数（BI）评分、神经功能缺损（SSS ）评分。结果2组治疗8周后BI评分均增加,SSS评分均减少（ P＜0.05）,治疗组较对照组的变化更显著（ P＜0.05）。治疗组治疗4周、8周后HAMD评分均较治疗前降低（P＜0.05）,与对照组相比,差异有统计学意义（P＜0.05）。结论帕罗西汀治疗脑卒中后抑郁障碍患者疗效确切,值得临床推广。     

Effects of paroxetine or milnacipran on serum brain-derived neurotrophic factor in depressed patients

Brain-derived neurotrophic factor (BDNF) is an important member of the neurotrophin family of growth factors, abundant in the brain and periphery. Researchers have reported that serum BDNF levels in drug-free depressed patients are lower than those of healthy controls, and have proposed that these low levels might reflect a failure of neuronal plasticity in depression. In the present study, we investigated the effects of paroxetine, an SSRI, and milnacipran, an SNRI, on serum BDNF levels in depressed patients. Serum levels of BDNF were measured by ELISA before, 4 weeks, and 8 weeks after the start of treatment with antidepressants. Forty-two patients were randomly administered paroxetine (21 cases) or milnacipran (21 cases). A negative correlation was found between serum BDNF levels and baseline Ham-D scores. The response and remission rates for each drug were not significantly different. Serum BDNF levels in responders were significantly increased 2.6- and 1.8-fold 8 weeks after treatment with paroxetine or milnacipran, respectively. These results suggest that both drugs improve the depressive state by increasing BDNF levels.     

帕罗西汀与阿米替林治疗抑郁症的对照研究

目的 探讨帕罗西汀治疗抑郁症的疗效和安全性。方法 61例抑郁症病人随机分为阿米替林组31例。帕罗西汀组30例。共治疗6周，采用汉密尔顿抑郁量表（HAMD）和临床总体评定量表（CGI）评定临床疗效，采用副反应量表（TESS）评定副反应。结果 帕罗西汀组与阿米替林组治疗前后HAMD和CGI-SI分值比较均有显著性差异。而两组减分相比治疗前后无显著性差异。帕罗西汀组副作用明显比阿米替林组轻，在植物神经，心血管以及神经系统方面二者有显著性差异。结论 帕罗西汀治疗抑郁症疗效好，副反应小，服用方便，依从性好，是治疗抑郁症的理想药物。     

帕罗西汀与阿米替林治疗抑郁症的对照研究

目的验证帕罗西汀治疗抑郁症的疗效及安全性.方法对60例抑郁症患者分别以帕罗西汀与阿米替林治疗,共治疗6周.采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体评定量表(CGI)评定临床疗效,采用副反应量表(TESS)评定副反应.结果帕罗西汀组与阿米替林组治疗前后HLAMD、HAMA、CGI-SI评分及减分比较均无显著性差异(P＞0.05).帕罗西汀组的副反应较阿米替林组少而轻,帕罗西汀常见的副反应有恶心、头晕、口干等.结论帕罗西汀治疗抑郁症的疗效同阿米替林相当,副反应少而轻.     

帕罗西汀与阿米替林治疗抑郁症临床对照研究

目的为探讨帕罗西汀对抑郁症的临床疗效及其副反应。方法应用帕罗西汀与阿米替林进行对照治疗研究，采用ＨＡＭＤ、ＴＥＳＳ量表及临床疗效评定标准分别评定疗效及副反应。结果提示帕罗西汀与阿米替林对抑郁症的疗效及显效时间近似；帕罗西汀副反应较阿米替林少且轻微。结论帕罗西汀和阿米替林对抑郁症均有较好的疗效，但帕罗西汀副反应轻微，服药方式简便，患者有较好的依从性，值得临床推广     

帕罗西汀与阿米替林治疗抑郁症的对照研究

６０例ＨＡＭＤ≥１８、符合ＤＳＭ－Ⅲ－Ｒ抑郁症诊断标准的患者，经６周随机、双盲、对照研究，ＨＡＭＤ、ＨＡＭＡ，ＣＧＩ、ＴＥＳＳ量表和临床疗效评定显示，帕罗西汀抗抑郁疗效肯定，显效率８３．３３％，与阿米替林７３．３４％相近，两者无显著差异。帕罗西汀治疗２周内见效，不良反应发生率和严重程度比阿米替林明显较少而轻，本研究证实，帕罗西汀是有效的抗抑郁剂，不良反应轻微。     

西酞普兰治疗脑卒中后抑郁对照研究

目的：比较西酞普兰与阿米替林治疗脑卒中后抑郁的疗效和安全性。方法：72例脑卒中后抑郁患者，随机分成两组，分别用西酞普兰和阿米替林治疗8周。采用汉密顿抑郁量表(HAMD)、Montgomerg-Asberg抑郁量表(MADS)和副反应量表(TESS)于治疗前和治疗后1、2、4、8周末分别评定疗效和不良反应。结果：西酞普兰组与阿米替林组间的HAMD、MADS评分差异均无显著性，西酞普兰组不良反应较阿米替林组少而轻。结论：西酞普兰治疗脑卒中后抑郁疗效好，安全性高，不良反应轻微。     

乌灵胶囊联合帕罗西汀治疗卒中后抑郁疗效观察

目的观察乌灵胶囊联合帕罗西汀治疗卒中后抑郁患者的疗效。方法将180例卒中后抑郁患者随机分为2组,实验组即乌灵胶囊联合帕罗西汀组92例,对照组即单用帕罗西汀组88例,疗程3个月。分别在治疗前和疗程结束后应用汉密尔顿抑郁量表(hamilton rating scale for depression,HAMD)评分来评估抑郁症状的改善情况,应用TESS不良反应量表(treatment emergent symptom scale,TESS)评估药物不良反应。结果实验组汉密尔顿抑郁量表评分较对照组明显降低,差异有统计学意义(P<0.05);2组TESS不良反应量表评分差异无统计学意义(P>0.05)。结论乌灵胶囊联合帕罗西汀治疗卒中后抑郁安全有效。