恶性血液病伴抑郁障碍患者抗抑郁治疗前后血浆P物质分析

目的探讨恶性血液病伴抑郁障碍患者抗抑郁治疗前后血浆P物质的变化。方法将46例恶性血液病伴抑郁障碍患者随机分为两组，每组各23例，均进行常规内科治疗。研究组在常规治疗的基础上对伴睡眠障碍者每晚口服米氮平15mg·d^-1治疗，无睡眠障碍者早晨口服氟西汀10mg·d^-1治疗，观察4w。于治疗前及治疗2w、4w末采用汉密顿抑郁量表评定抑郁状况；于治疗前及治疗4w末采集空腹静脉血应用放射免疫法测定血浆P物质浓度。结果研究组治疗2w末起汉密顿抑郁量表总分均较治疗前显著下降（P〈0．01），对照组下降无显著性差异（P〉0．05）；两组比较差异均有极显著性（P〈0．01）。两组内及两组间治疗前后各时段血浆P物质水平均无显著性差异（P均〉0．05）。结论抗抑郁治疗可改善恶性血液病患者伴发的抑郁症状，但对血浆P物质水平无明显影响。

The changes of substance P plasma levels before and after antidepressive treatment in malignant hematonosis patients accompanied with depressive disorder

Objective To explore the changes of substance P(SP) plasma levels before and after antidepressive treatment in malignant hematonosis patients accompanied with depressive disorder.Methods 49 malignant hematogenesis pantients accompanied with depressive disorder were randomly divided into research group(n=25) receiving routine medical treatment plus mirtazapine oral 15mg/d q.n.in the patients with sleep disorders or fluoxetine 10mg/d in the morning in ones without and control group doing routine medical treatment alone for 4 weeks.Depressive states were assessed with the Hamilton Depression Rating Scale(HAMD) before treatment and at the ends of the 2nd and 4th week treatment;SP fasting plasma levels were detected using radioimmunity before treatment and at the end of the 4th week.Results Since the end of the 2nd week,the HAMD total score lowered very significantly compared with pretreatment in the research group(P<0.01) and there was no significant difference in the control group(P>0.05);there was very significant difference between the 2 groups(P<0.01).There was no intra-and inter-group significant differences in SP plasma levels of each time-section(all P>0.05).Conclusion Antidepressive treatment can improve the depressive symptoms of malignant hematogenesis patients and has no notable effects on SP plasma levels.