氟伏沙明与阿米替林改善抑郁症认知损害的P300对照研究

目的比较氟伏沙明与阿米替林对抑郁症患者认知功能的影响。方法将60例符合《中国精神障碍分类与诊断标准——第3版》（CCMD-3）抑郁症诊断标准患者作为实验组，与实验组性别、年龄匹配的30例健康人作为对照组。随机将实验组分为氟伏沙明治疗组（实验组1，n=30）及阿米替林组（实验组2，n=30），治疗8周前后予P300检测及汉密顿抑郁量表（HAMD）评定，比较各组P300各成分及HAMD评分的差异。结果与对照组相比，治疗前实验组1及实验组2P2、N2、P3潜伏期及反应时间明显延长，P2、N2、P3波幅明显降低，差异具有显著性意义（P〈0．05或P〈0．01）；治疗后，实验组1P2、N2、P3潜伏期及反应时间比治疗前明显缩短，P2、N2、P3波幅明显增高，差异有显著性意义（P〈0．05或P〈o．01）；实验组2P2、N2、P3潜伏期及反应时间比治疗前明显降低（P〈0．05或P〈0．01），但P2、N2、P3波幅与治疗前比较差异无显著性意义（P〉0．05）。结论抑郁症患者存在认知功能障碍，氟伏沙明具有明显改善抑郁症认知功能的作用。

Comparative study on fluvoxamine and amitriptyline in treatment of cognitive impairment in patients with depression using P300

Objective To compare the effects of fluvoxamine and amitriptyline on cognitive impair- ment in patients with depression. Methods Sixty patients meeting with CCMD--3 for Depression criteria were enrolled as research group and thirty healthy individuals were selected as normal control group. The research group was further divided into fluvoxamine treated group （research group 1, n = 30） and amitriptyline treated group （research group 2, n = 30） randomly. The research groups were assessed with HAMD and measured with Auditory evoked event--related potential P300 before and after 8 weeks treatment. P300 factors of all groups and HAMD scores of research group1, 2 before and after treatment were compared with each other respectively. Results The latency and reactive time of P2, N2, and P3 prolonged and the amplitude of P2, N2 and P3 reduced significantly in research groups compared to normal control group （P 〈0.05 or P 〈 0.01） ; After treatment, the latency and reactive time of P2, N2 and P3 reduced and the amplitude of P2, N2 and P3 remarkably increased compared to that before treatment in research group 1 （P 〈 0. 05 or P 〈 0. 01）, reduced in research group2 （P 〈 0.05 or P 〈0.01） ; however, there are no significant differences in the amplitude of P2, N2 and P3 between before and after treatment in research group 2 （P〈0.05）. Conclusions The presence of cognitive impairment in the depression has been confirmed. Fluvoxamine presents significant effects on improving cognitive impairment in patients with the depression.