阿戈美拉汀与氟哌噻醇美利曲辛治疗围绝经期综合征的对照研究

目的:比较阿戈美拉汀与氟哌噻醇美利曲辛治疗围绝经期综合征的疗效差异。方法:选取门诊围绝经期综合征患者50例,随机分为阿戈美拉汀组(25例)和氟哌噻醇美利曲辛组(25例)。入组第1周给予阿戈美拉汀25 mg/d或氟哌噻醇美利曲辛1片/d,随后剂量由医师根据病情需要调整,阿戈美拉汀剂量不超过50 mg/d,氟哌噻醇美利曲辛不超过2片/d。用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)总分和减分率评定疗效。结果:阿戈美拉汀和氟哌噻醇美利曲辛均能有效改善围绝经期妇女的抑郁症状(P0.01);第4周阿戈美拉汀组改善焦虑症状方面优于氟哌噻醇美利曲辛组(P0.01),差异有显著性;但在第8周末,阿戈美拉汀组总有效率92%(23/25),氟哌噻醇美利曲辛组总有效率为84%(21/25),两组疗效差异无统计学意义。两组治疗期间的不良反应差异无统计学意义(P0.05)。结论:经8周治疗,阿戈美拉汀和氟哌噻醇美利曲辛对围绝经期综合征抑郁和焦虑均具有较好的疗效,且两者疗效相当,但阿戈美拉汀起效快,尤其在改善焦虑症状方面。     

舒肝解郁胶囊联合阿戈美拉汀治疗肝癌合并抑郁患者的效果

目的 探讨舒肝解郁胶囊联合阿戈美拉汀治疗肝癌合并抑郁患者的临床疗效。方法 选择我院2017年6月～2020年1月108例肝癌合并抑郁患者,按照数字表法均分为两组,各54例,对照组给予阿戈美拉汀治疗,观察组在此基础上联合服用舒肝解郁胶囊,共治疗8周。比较治疗前后汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)以及病灶最大直径,评价治疗后抑郁疗效以及治疗期间不良反应发生率、阿戈美拉汀用量。结果 两组治疗后HAMD评分、PSQI指数、HAMA评分、病灶最大直径均显著降低,且治疗后观察组三项评分及病灶最大直径均显著低于对照组,(P0.05);观察组治疗总有效率显著高于对照组,(P0.05);两组不良反应发生率差异无统计学意义(P0.05),观察组阿戈美拉汀用量显著低于对照组,(P0.05)。结论 肝癌合并抑郁患者采用舒肝解郁胶囊联合阿戈美拉汀治疗能够显著改善焦虑、抑郁情绪以及睡眠质量,提升肿瘤化疗效果,且不增加不良反应发生率。     

阿戈美拉汀联合碳酸锂缓释片治疗双相抑郁的疗效观察

目的 探讨阿戈美拉汀联合碳酸锂缓释片治疗双相抑郁的疗效研究.方法 按照DSM-5标准,纳入86例双相抑郁患者,按照随机数字法将患者分配至治疗组和对照组,治疗组给予碳酸锂缓释片+阿戈美拉汀,对照组给予碳酸锂缓释片,随访12周.结果 两组之间17项汉密尔顿抑郁量表减分率,在2周、4周、8周、12周访视期均存在差异,治疗组减...     

阿戈美拉汀与帕罗西汀治疗抑郁症失眠的疗效对比

目的对比帕罗西汀和阿戈美拉汀治疗抑郁症失眠的疗效。方法选取2017-01—2020-01新乡医学院第二附属医院治疗的抑郁症失眠患者150例,依据随机化原则分为阿戈美拉汀组(n=75)和帕罗西汀组(n=75),观察2组患者的抑郁程度、焦虑程度、睡眠质量、生活质量、临床疗效、不良反应发生情况。结果阿戈美拉汀组患者治疗后较治疗前的HAMD评分、HAMA评分、PSQI评分降低幅度及SF-36评分升高幅度均显著高于帕罗西汀组(P<0.05)。阿戈美拉汀组总有效率为96.0%(72/75),帕罗西汀组为68.0%(51/75),阿戈美拉汀组显著高于帕罗西汀组(P<0.05)。在不良反应发生率方面,阿戈美拉汀组为9.3%(7/75),帕罗西汀组为12.0%(9/75),2组比较差异无统计学意义(P>0.05)。结论阿戈美拉汀治疗抑郁症失眠的疗效显著优于帕罗西汀。     

不同抗抑郁药物对抑郁症患者血清S100B蛋白和BDNF浓度与认知功能的影响

目的探究不同抗抑郁药物对抑郁症患者血清S100B蛋白(S100B)和血清脑源性神经营养因子(BDNF)浓度与认知功能的影响。方法将120例抑郁症患者采用随机数表法分为观察组和对照组,每组60例。观察组予以阿戈美拉汀治疗,对照组予以文拉法辛治疗。比较2组治疗前、治疗6w后症状[汉密尔顿抑郁量表(HAMD)、蒙哥马利抑郁量表(MARDS)],认知功能[重复性成套神经心理状态测验(RBANS)],愉快体验感受[斯奈思-汉密尔顿快感量表(SHAPS)]、血清S100B及BDNF水平的差异,并记录2组不良反应发生率。结果治疗6w后,2组症状严重程度(HAMD、MARDS得分)、SHAPS得分和S100B水平均低于治疗前(P0.05),2组RBANS得分和BDNF水平均高于治疗前(P0.05),且观察组变动幅度大于对照组(P0.05)。结论阿戈美拉汀应用于抑郁症患者效果优于文拉法辛,S100B和BDNF指标水平更优,同时在改善患者疾病症状、认知功能和愉悦体验中作用也更明显。     

阿戈美拉汀治疗重度抑郁症的临床疗效

目的 探讨新型抗抑郁药物阿戈美拉汀在治疗重度抑郁患者方面的临床疗效和安全性.方法 选取我院2013年2月～2014年2月收住院的重度抑郁症患者58例随机分为两组,研究组应用阿戈美拉汀25～50mg/d,平均剂量（46.36±4.48）mg/d,对照组选用艾司西酞普兰10～20mg/d,平均剂量（16.83±2.94）mg/d,均治疗8周.治疗前及治疗后第2,4,8周分别采用汉密尔顿抑郁量表（HAMD-17）对两组进行评估,在治疗过程中应用治疗不良反应量表（TESS）进行测量.结果 治疗2周后研究组HAMD减分为（8.36±4.07）分,对照组为（6.19±3.68）分,两组减分情况比较差异有统计学意义（q=3.38,P＜0.05）.治疗8周后阿戈美拉汀组HAMD减分为（18.15±4.29）分,艾司西酞普兰组HAMD减分为（16.26±3.83）分,两组减分情况比较差异有统计学意义（q=4.12,P＜ 0.05）.药物安全性方面,研究组主要不良反应依次是头痛（5例）、便秘（4例）和肝功能异常（3例）;对照组主要不良反应依次是头痛（9例）、恶心呕吐（6例）和血压升高（5例）.TESS总分比较,研究组（3.42±1.24）分低于对照组（4.08±1.69）分,差异有统计学意义（t=7.45,P＜0.01）.结论 阿戈美拉汀在治疗重度抑郁症方面,较艾司西酞普兰起效快,疗效明显,不良反应少.     

阿戈美拉汀联合重复经颅磁刺激治疗老年惊恐障碍的临床研究

目的:探讨阿戈美拉汀联合重复经颅磁刺激(rTMS)对老年惊恐障碍患者疗效及对认知功能的影响。方法:60例老年惊恐障碍患者随机分为研究组(n=30)和对照组(n=30),两组在rTMS治疗的基础上,研究组联合阿戈美拉汀片治疗;疗程12周。治疗前后采用惊恐障碍相关症状量表(PASS)、临床疗效总评量表-病情严重度(CGI-SI)和汉密尔顿焦虑量表(HAMA)评定疗效;使用威斯康星卡片分类测验(WCST)、韦氏记忆测验(WMS)评定认知功能;采用治疗中出现的症状量表(TESS)评定治疗的安全性。结果:治疗4周后两组PASS、CGI-SI和HAMA评分较治疗前明显下降;治疗8周后研究组PASS、CGI-SI和HAMA评分显著低于对照组(P0.05或P0.01)。两组TESS评分比较差异无统计学意义。治疗后两组WCST与WMS中各项评分均较治疗前明显改善。结论:阿戈美拉汀片治疗老年惊恐障碍安全、有效,rTMS联合阿戈美拉汀片可以提高疗效,同时改善老年惊恐障碍患者的记忆和认知功能。     

八段锦结合阿戈美拉汀治疗抑郁症伴失眠患者的疗效观察

目的 观察八段锦结合阿戈美拉汀治疗抑郁症伴失眠患者的临床疗效.方法 选取58例抑郁症伴失眠的住院患者,按照随机数字表法分为对照组29例,八段锦组29例,2组病人均给予阿戈美拉汀片口服,在此基础上八段锦组每日加用八段锦保健功法辅助治疗,观察治疗8周后2组病人汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)...     

阿戈美拉汀治疗首发抑郁症的临床效果

目的观察阿戈美拉汀治疗首发抑郁症的有效性及安全性。方法将76例首发抑郁症患者按照随机数字表法分为阿戈美拉汀组和氟西汀组各38例,分别以阿戈美拉汀25~50 mg/d和氟西汀20~40 mg/d治疗,两组均治疗6周。分别于治疗前及治疗第1、2、4、6周末采用汉密尔顿抑郁量表17项版(HAMD-17)评定临床疗效,于治疗6周末采用副反应量表(TESS)评定药物的安全性。结果阿戈美拉汀组有效率为86.84%,氟西汀组有效率为84.21%,两组差异无统计学意义(P0.05);在治疗第1、2周末,阿戈美拉汀组HAMD-17总评分及焦虑/躯体化、睡眠障碍因子评分均低于氟西汀组,差异均有统计学意义(P均0.05)。治疗6周末,两组TESS评分比较差异无统计学意义[(2.92±2.11)分vs.(3.42±2.13)分,P0.05]。结论阿戈美拉汀对首发抑郁症的疗效较好、安全性较高,尤其适用于伴有焦虑、失眠的抑郁症患者。     

舍曲林+阿戈美拉丁治疗脑卒中后抑郁伴失眠的疗效观察

目的 分析脑卒中后抑郁（PSD）伴失眠患者应用舍曲林+阿戈美拉丁治疗的疗效。方法收集蚌埠医学院第一附属医院2022-01—2022-12收治的PSD伴失眠患者52例,盐酸舍曲林单药应用作为对照组（n=26）,阿戈美拉汀联合应用为观察组（n=26）。比较2组患者治疗前、治疗第4、8周后的失眠严重程度指数（ISI）、汉密顿抑郁量表（HAMD）评分,评价改善失眠及抗抑郁的有效率。结果 8周后观察组与对照组HAMD及ISI分别为（11.12±4.48）分、（11.12±4.48）分与（8.54±3.22）分、（11.08±4.34）分;观察组抗抑郁与改善失眠总有效率分别为84.62%(22/26)、88.46%(23/26),对照组抗抑郁与改善失眠总有效率均为57.69%(15/26),观察组显著高于对照组（P<0.05）。2组患者药物不良反应比较差异无统计学意义（P>0.05）。结论 舍曲林+阿戈美拉丁可显著改善PSD伴失眠患者的抑郁和失眠症状。     

视频脑电图在小儿癫痫诊断中的应用

目的评价视频脑电图(video-EEG)在小儿癫诊断中的应用价值。方法对126例具有发作性症状的患儿进行连续8h的包括清醒、睡眠、诱发试验及必要的认知测验的视频脑电图监测。结果经发作期视频脑电图证实,39例初诊为癫性发作的患儿中14例(35%)为非癫性发作;15例其他症状发作中13例(86%)为非癫性发作。64例样放电患儿中51例(80%)确定发作类型,22例(34%)确定癫类型。视频脑电图可发现短暂轻微的癫发作及样放电引起的一过性认知损伤。结论视频脑电图在排除非癫性发作、确定癫性发作的类型、评价脑电-临床关系方面可提供准确可靠的证据,进一步提高癫的临床诊断水平。     

Role of glutathione in repair of free radical damage in hippocampus in vitro.

Depletion of glutathione (GSH), an intrinsic antioxidant, increases vulnerability to free radical damage in a number of cell systems. This study investigates the role of GSH in limiting electrophysiological damage and/or recovery from free radical exposure in slices of guinea pig hippocampus. Synaptic potentials (PSPs) and population spikes (PSs) were recorded from field CA1. Free radicals were generated from 0.006% peroxide through the Fenton reaction. Analysis of the input-output curves showed that peroxide treatment decreased PSPs and impaired ability of the PSPs to generate PSs as previously reported. Recovery was nearly total within a half hour. Treatment with 5 mM buthionine sulfoximine (BSO) for 2 h depleted hippocampal GSH to 79.2% of control values. The extent of free radical damage was not increased. Recovery, however, was only partial. GSH was further depleted by oxidation with diamide or covalent bonding with dimethyl fumarate (DMF) immediately before and during the peroxide treatment. Neither diamide nor DMF treatment in BSO-incubated tissue enhanced peroxide-induced electrophysiological deficits. Following these treatments, however, tissue showed little recovery from free radical damage. We conclude that glutathione is essential for repair processes in hippocampal neurons exposed to oxidative damage.     

Neuroprotective properties of memantine in different in vitro and in vivo models of excitotoxicity

The pathogenesis of stroke, trauma and chronic degenerative diseases, such as Alzheimer's disease (AD), has been linked to excitotoxic processes due to inappropriate stimulation of the N-methyl-D-aspartate receptor (NMDA-R). Attempts to use potent competitive NMDA-R antagonists as neuroprotectants have shown serious side-effects in patients. As an alternative approach, we were interested in the anti-excitotoxic properties of memantine, a well-tolerated low affinity uncompetitive NMDA-R antagonist presently used as an anti-dementia agent. We explored in a series of models of increasing complexity, whether this voltage-dependent channel blocker had neuroprotective properties at clinically relevant concentrations. As expected, memantine protected neurons in organotypic hippocampal slices or dissociated cultures from direct NMDA-induced excitotoxicity. However, low concentrations of memantine were also effective in neuronal (cortical neurons and cerebellar granule cells) stress models dependent on endogenous glutamate stimulation and mitochondrial stress, i.e. exposure to hypoxia, the mitochondrial toxin 1-methyl-4-phenylpyridinium (MPP+) or a nitric oxide (NO) donor. Furthermore, memantine reduced lethality and brain damage in vivo in a model of neonatal hypoxia-ischemia (HI). Finally, we investigated functional rescue (neuronal capacity to migrate along radial glia) by memantine in cerebellar microexplant cultures exposed to the indirect excitotoxin 3-nitropropionic acid (3-NP). Potent NMDA-R antagonists, such as (+)MK-801, are known to block neuronal migration in microexplant cultures. Interestingly, memantine significantly restored the number of neurons able to migrate out of the stressed microexplants. These findings suggest that inhibition of the NMDA-R by memantine is sufficient to block excitotoxicity, while still allowing some degree of signalling.     

Knowledge of management of epilepsy in young adults in Jordan

PURPOSE: Nationwide studies on public knowledge of epilepsy have been undertaken in several countries, but not in Jordan. The purpose of this study was to evaluate knowledge of the management of epilepsy in Jordan. METHODS: A cross-sectional study was performed during the period February-June 2005 on 16,044 individuals selected randomly to represent all regions of Jordan. Respondents were interviewed and asked to complete a five-item questionnaire testing their knowledge of the management of epilepsy. RESULTS: Most of the individuals (77.9%) agreed that patients with epilepsy are best treated in a specialized hospital for neurological diseases. Although the largest percentage of the sample (86.7%) agreed that the best person to treat epilepsy is a neurologist, others believed that a hypnotherapist (25.4%) or a religious healer (22.6%) is. As an immediate measure during an attack of epilepsy, most respondents (82.6%) agreed that protecting the patient's head is most important. During the postseizure period, 45.8% of respondents believed that offering the patient water or a cold or hot drink is appropriate. Two-thirds of the respondents (66.2%) agreed that epilepsy can be treated with drugs. Responses of the participants to the five items significantly differed with respect to age, gender, level of education, and occupation. CONCLUSION: Jordanians are reasonably well informed about most aspects of the management of epilepsy, but there is still a need for public education about this disorder.