伴维生素B12缺乏老年抑郁症临床对照研究  

Clinical control studies of senile depression with vitamin B12 deficiency

作　　者：徐广军[1] 赵约翰[1] 戴力[1] 

机构地区：[1]潍坊市人民医院临床心理科,山东潍坊261061

出　　处：《临床心身疾病杂志》2010年第3期212-214,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的了解老年抑郁症患者血清维生素B。z水平，评价抗抑郁剂联合维生素B，z治疗老年抑郁症伴维生素B，z缺乏的临床疗效及安全性。方法对200例老年抑郁症患者进行血清维生素B。。浓度测查，将筛查出的维生素B1：缺乏72例患者随机分为两组，每组36例。两组均顿服米氮平治疗，研究组在此基础上联合维生素B12治疗，观察8周。于治疗前及治疗第1周、2周、4周、8周末采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果老年抑郁症伴发维生素B12缺乏的发生率为36％。治疗后两组汉密顿抑郁量表总分均较治疗前有显著下降（P〈0．01），同期研究组均较对照组下降显著（P〈0．01）。治疗8周末，研究组显效率77．8％，总有效率94．4％；对照组分别为47．2％、72．2％。研究组显效率，总有效率显著高于对照组（X2=7．170、6．400，P〈0．01）。两组不良反应均轻微，主要表现为头昏、厌食、失眠、无力等。结论老年抑郁症患者血清维生素B12缺乏发生率高，抗抑郁剂联合维生素B12治疗可显著提高临床疗效，且安全性高，有利于老年抑郁症患者的全面康复。Objective To understand serum vitamin B12 levels in senile depression patients and evaluate the clinical efficacy and safety of antidepressant combined with vitamine Ble in the treatment of senile depression with vitamin B12 deficiency. Methods Serum vitamine B12 levels were detected in 200 senile depression patients, screened 72 ones with vitamin B12 deficiency were randomly divided into two groups of 36 patients each. Both groups took a draught of mirtazapine, research group was plus vitamine B12, for 8 weeks. Clinical efficacies were assessed with the Hamilton Depression Scale（HAMD） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of the 1st, 2nd, 4th and 8th week. Results The incidence of vitamin B12 deficiency senile depression patients was 36 %. After treatment, the total scores of the HAMD of both groups lowered more significantly compared with pretreatment（P〈0.01）, those did more significantly in the research than in the control group in the corresponding time period（P〈0. 01）. At the end of the 8th week, obvious and total effective rates were 77. 8% and 94.4% in the research and 47.2% and 72.2% in the control group,respectively, the former were signifi- cantly higher than the latter（x2 = 7. 170,6. 400, P〈0.01）. mainly dizziness, anorexia, insomnia, asthenia and so on. Adverse reactions of both groups were mild and Conclusion The incidence of vitamin B12 deficiency in senile depression patients is high, antidepressant combined with vitamine B12 could increase clinical efficacy notably, has higher safety and makes for comprehensive rehabilitation of senile depression pa tients.

关 键 词：老年抑郁症 维生素B12缺乏 血清 临床疗效 安全性 汉密顿抑郁量表 副反应量表 

分 类 号：R749.4[医药卫生—神经病学与精神病学]