氟西汀治疗维持性血液透析并发抑郁症20例

目的观察氟西汀治疗慢性肾衰竭维持性血液透析并发抑郁症的疗效与安全性。方法将40例并发抑郁症的慢性肾衰竭维持性血液透析患者随机分为两组，治疗组在卫生宣教的基础上加用氟西汀20mg，PO，qd，3周为1个疗程；对照组进行常规卫生宣教。采用Zung抑郁自评量表（SDS）评定临床疗效，采用肾脏疾病生活质量简表（KDQOL-SF）评定两组生活质量，同时采用需要处理的不良反应表（TESS）评定安全性。结果治疗组SDS减分率明显高于对照组（P〈0．05）；治疗组总有效率为75．0％，对照组为25．0％，治疗组明显高于对照组（P〈0．05）；治疗组治疗后KDQOL-SF分值明显升高（P〈0．05）；氟西汀不良反应主要有早期一过性轻微胃肠道不适。结论氟西汀对慢性肾衰竭维持性血液透析并发抑郁症的患者具有赴好的疗效和安全性。

Treatment of 20 Cases of Depression Complicated by Sustained Hemodialysis with Fluoxetine

Objective To survey the therapeutic effectiveness and safety rate of fluoxetine in the treatment of depression complicated by sustained hemodialysis in patients with chronic renal failure. Methods 40 cases of depression complicated by sustained hemodialysis in patients with chronic renal failure were randomly divided into two equal groups: the trial group and control group.On the basis of conventional health propaganda and education,patients of the trial group were given each 20 mg of fluoxetine PO,q.d.,for 3 consecutive weeks.Patients of the control group were subjected only to health propaganda and education.The therapeutic effectiveness was accessed with the Zung Self-Rating Depression Scale(SDS);the quality of life was evaluated with the Kidney Disease Quality of Life Short Form(KDQOL-SF) while the safety rate was appraised with the Treatment Emergent Rating Scale(TESS). Results The overall effective rates in patients of the trial group and control group were 75% and 25%,respectively(P<0.05).There was a much greater decrease in the score of SDS after the treatment in patients of the trial group than that in patients of the control group(P<0.05).The Scoring assessed with the KDQOL-SF was strikingly increased after the treatment in patients of the trial group(P<0.01).The major adverse reaction caused by fluoxetine was a transient and slight gastro intestinal discomfort early in the course of treatment. Conclusion Fluoxetine was shown to be fairly effective and safe in the treatment of depression complicated by sustained hemodialysis in patients with chronic renal failure.