文拉法辛与氟西汀治疗对老年期抑郁症患者的事件相关电位P300的影响

目的比较文拉法辛缓释剂与氟西汀对老年期抑郁症患者认知功能的影响.方法将60例（年龄≥60岁）符合《中国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.随机将实验组分为氟西汀治疗组（实验组1）及文拉法辛治疗组（实验组2）,对两组在治疗前、治疗8周后进行听觉诱发事件相关电位P300检测及汉密顿抑郁量表（HAMD）评定.与实验组性别、年龄匹配的正常老年人60例最为对照组,与实验组1相匹配的为对照组1,与实验组2相匹配的为对照组2.比较各组之间治疗前后事件相关电位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、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＜0.01）,P3潜伏期与治疗前差异无显著性意义（P＞0.05）;实验组2P2、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＜0.01）;实验组1P3潜伏期及反应时间比实验组2明显延长,差异有显著性意义（P＜0.05或P＜0.01）;实验组2HAMD评分明显高于实验组1,差异有显著性意义（P＜0.01）.结论老年期抑郁症患者存在认知功能障碍,文拉法辛对老年期抑郁症认知功能的影响好于氟西汀.

Comparison of event - related potential P300 in the geriatric depression treated with venlafaxine or fluoxetine

Objective: To compare the effects of venlafaxine and fluoxetine on cognitive function in the senile depression.Methods: Sixty patients(no less than 60 years old) met with CCMD-3 for Depression criteria were enrolled as research group and sixty healthy persons marched for sexual and age were selectde as normal control group.The research group was divided into fluoxetine treated group(research group 1) and venlafaxine treatde group(research group 2) randomly.The normal control group was divided into normal control group 1 and normal control group 2 marched for research group 1 and research group 2.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 group 1,2 before and after treatment were compared with each other respectively.Results:The latency and reachive time of P2,N2 and P3 prolonged and the amplitude of P2,N2 and P3 reduced in research group 1,2 compared with normal control group (P<0.05 or P<0.01);After treatment,the latency and reactive time of P2,N2 reduced and the amplitude of P2,N2 and P3 hoisted compared with before treatment in research group 1 (P<0.05 or P<0.01);There is no significant difference of the latency P3 of research group 1 between before and after treatment (P>0.05),the latency and reactive time of P2,N2 and P3 reduced and the amplitude of P2,N2 and P3 hoisted compared with before treatment in research group 2 (P<0.05 or P<0.01);The latency and reactive time of research group 1 P3 prolonged compared with research group 2 (P<0.05 or P<0.01);The HAMD scores of research group 2 are more than research group 1 after treatment (P<0.01).Conclusion:The presence of cognitive dysfunction in the senile depression has been confirmed.The study suggests that the effects of venlafaxine on cognitive function is better than that of fluoxetine.