SSRI和SNRI药物对未治抑郁症患者执行功能影响的对照研究  

Effects of SSRIs and SNRIs on the executive function in the untreated patients with unipolar major depression

作　　者：路亚洲[1] 李晓虹[1] 任艳萍[1] 王刚[1] 王雪梅[1] 罗炯[1] 孙学礼[2] 

机构地区：[1]首都医科大学附属北京安定医院,北京100088 [2]四川大学华西医院心理卫生中心

出　　处：《精神医学杂志》2010年第5期330-333,共4页Journal of Psychiatry

基　　金：国家十五公关课题资助项目;课题编号为2004DA7210A21

摘　　要：目的比较舍曲林、帕罗西汀和文拉法辛缓释剂对未治抑郁症患者的执行功能影响。方法对52例未治抑郁症患者随机分组,给予6周的舍曲林(n=11)、帕罗西汀(n=17)或文拉法辛缓释剂(n=24)治疗,使用威斯康星卡片分类测验(WCST)、汉诺塔测验(TOH)、连线测验A、B(TMT-A、B)、词语流畅性测验(VFT),评定患者治疗前后的执行功能。使用汉密尔顿抑郁量表-17项(HAMD-17)、汉密尔顿焦虑量表(HAMA),评定患者治疗前后的临床症状。结果 (1)治疗前后三组间神经心理学测验变化值比较,文拉法辛组的WCST分类个数(1.1±1.3)高于帕罗西汀组(0.2±0.6),差异有统计学意义(P=0.014);(2)各组治疗后测验结果均明显改善,其中WCST持续错误数,TOH总分、任务数比较,差异有统计学意义(均P<0.05);(3)WCST正确数变化与焦虑/躯体化因子变化呈负相关(P=0.032),TOH平均执行时间与躯体化焦虑因子变化呈正相关(P=0.019),TOH总分变化与HAMD总分变化值呈负相关(P=0.033)。结论舍曲林、帕罗西汀和文拉法辛缓释剂对抑郁症患者执行功能均有改善作用,三者疗效相当,但文拉法辛改善执行功能增幅最大,更具潜力。Objective To compare the effects of sertraline, paroxetine and venlafaxine extended release on executive function in the untreated patients with unipolar major depression. Methods During the treatment of six weeks, 52 patients were randomized divided to receiving sertraline （n = 11 ）, or paroxetine （ n = 17）, or venlafaxine extended release （n = 24） , using a battery of executive tests, including the modified version of Wisconsin Card Sorting Test （WCST）, the Tower of Hanoi （TOH） , the Trail Making Test -A and B （TMT -A, B） , Verbal Fluency Test（ VFT） to evaluate the executive function, and using HAMD - 17 and HAMA to evaluate the clinical symptoms. Results （ 1 ） In comparison with the change of scores of all tests between before and after treatment, sorting number of WCST （ 1.1 ± 1.3） in venlafaxine group got significantly higher than that（0.2 ± 0.6） in paroxetine group （ P = 0.014） ; （2） The seors of all tests in the patients were improved after treatment. , and there were significant differences of WCST correct number, preservative errors, TOH total score, task number in each group between before and after treatment （ P 〈 0.05 ） ; （ 3 ） There had significantly negative correlation between the changes of correct number in WCST and arrxiety/somatization factor（ P = 0. 032） ,positive correlation between mean executive time of TOH and physical anxiety factor （P =0.019） ,negative correlation between TOH total score and HAMD total score （P = 0. 033 ）. Conclusion Sertraline, paroxetine and venlafaxine extended release all could have equal efficacy to improve the executive function of patients with unipolar major depression, but venlafaxine seems to be better potentiality to improve executive function.

关 键 词：抑郁症 执行功能 舍曲林 帕罗西汀 文拉法辛 

分 类 号：R749.4[医药卫生—神经病学与精神病学]