氟伏沙明对住院青少年抑郁障碍患者脂代谢的影响

背景 氟伏沙明被越来越多地用于青少年抑郁障碍的治疗，但目前关于氟伏沙明对脂代谢影响的研究较有限，而脂代谢紊乱会严重危害患者的身体健康并影响预后。目的 分析氟伏沙明对青少年抑郁障碍患者脂代谢的影响，探讨氟伏沙明治疗的安全性。方法 连续选取2022年6月—2023年6月山西省精神卫生中心住院部收治的、符合《国际疾病分类（第10版）》（ICD-10）诊断标准的60例青少年抑郁障碍患者为研究对象。采用随机数字表法分为研究组（氟伏沙明治疗）和对照组（舍曲林治疗）各30例，疗程4周。于基线期、治疗2周和4周后，检测两组空腹脂代谢指标，包括血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL），并进行汉密尔顿抑郁量表17项版（HAMD-17）评定。比较两组不同随访时间的脂代谢指标水平及HAMD-17评分。结果 HAMD-17评分的时间效应有统计学意义（F=849.687，P<0.01），组间效应和交互效应均无统计学意义（F=0.033、1.760，P均>0.05）。TC水平的组间效应无计学意义（F=1.461，P=0.232），时间效应与交互效应均有统计学意义（F=13.129、5.029，P<0.05或0.01）。TG水平的时间效应和组间效应均无统计学意义（F=0.825、0.185，P均>0.05），交互效应有统计学意义（F=7.577，P=0.004）。HDL水平的时间效应、组间效应以及交互效应均无统计学意义（F=1.079、0.160、1.877，P均>0.05）。LDL水平的组间效应无统计学意义（F=0.019，P=0.891），时间效应和交互效应均有统计学意义（F=6.721、9.075，P均<0.01）。结论 氟伏沙明与舍曲林对青少年抑郁障碍的疗效相当，短期应用氟伏沙明对患者脂代谢指标的影响较小。

Effect of fluvoxamine on lipid metabolism in hospitalized adolescent patients with depressive disorder

Background Fluvoxamine is increasingly used in the treatment for depressive disorder in adolescents. However， little research has been done on the effect of fluvoxamine on lipid metabolism， and the disordered lipid metabolism would cause severe harm to the health of patients and affect relevant prognosis.Objective To analyze the effect of fluvoxamine on lipid metabolism in adolescent patients with depressive disorder and to investigate the safety of fluvoxamine treatment.Methods From June 2022 to June 2023， 60 adolescent patients with depressive disorder were involved， who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） and received inpatient treatments in Shanxi Mental Health Center. These cases were randomly divided into study group （receiving fluvoxamine treatment） and control group （receiving sertraline treatment） with 30 cases in each group. The treatment period was 4 weeks. At baseline as well as 2 weeks and 4 weeks after treatment， both groups'' indexes of fasting lipid metabolism were measured， including serum total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein （HDL） and low-density lipoprotein （LDL）， and Hamilton Depression Scale-17 item （HAMD-17） was adopted. The levels of lipid metabolism indexes and HAMD-17 score were compared between the two groups at different follow-up time points.Results For HAMD-17 score， the time effect was statistically significant （F=849.687， P<0.01）， while the inter-group effect and interaction effect was not statistically significant （F=0.033， 1.760， P>0.05）. For TC levels， the inter-group effect was not statistically significant （F=1.461， P=0.232）， but the time effect and interaction effect were statistically significant （F=13.129， 5.029， P<0.05 or 0.01）. The time effect and the inter-group effect of TG level were not statistically significant （F=0.825， 0.185， P>0.05）， but the interaction effect was statistically significant （F=7.577， P=0.004）. For HDL levels， the time effect， inter-group effect and interaction effect were not statistically significant （F=1.079， 0.160， 1.877， P>0.05）. For LDL levels， there was no statistical significance in the inter-group effect （F=0.019， P=0.891）， while statistical significance was observed in both time effect and interaction effect （F=6.721， 9.075， P<0.01）.Conclusion Fluvoxamine and sertraline have curative effectiveness of same level on adolescent depression disorder， and short-term application of fluvoxamine has little effect on lipid metabolism indexes of patients. ［www.chictr.org.cn number： ChiCTR2300074129］