度洛西汀对抑郁症多导睡眠图及主观睡眠质量的影响  

Effect of duloxetine on polysomnography and subjective sleep quality of the patients with retardative depression and non-retardative depression

作　　者：甘景梨[1] 陈巧平[2] 段惠峰[1] 

机构地区：[1]91医院全军精神疾病防治中心,河南焦作454003 [2]顺德第一人民医院心理科,广东佛山528300

出　　处：《实用医药杂志》2011年第3期204-207,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的研究度洛西汀对阻滞性和非阻滞性抑郁症患者多导睡眠图(PSG)和主观睡眠质量的影响。方法将符合中国精神障碍分类与诊断标准第3版(CCMD-3)中抑郁发作标准纳入观察的抑郁症患者32例按汉密尔顿抑郁量表(HAMD)阻滞因子的得分,分为阻滞组16例和非阻滞性组16例,两组均采用度洛西汀治疗,疗程4周。治疗前后采用PSG测定睡眠特点,匹兹堡睡眠质量指数(PSQI)评定主观睡眠质量,HAMD减分率评定疗效。结果阻滞组治疗前和治疗后PSQI评分与非阻滞组相比无显著差异(P>0.05);两组治疗后PSQI评分均显著低于治疗前(P<0.05)。阻滞组和非阻滞组治疗后觉醒次数和觉睡比增加,睡眠效率降低,S1百分比增加,SWS时间延长,快速眼动(REM)睡眠百分比及睡眠时间减少,REM睡眠潜伏期延长,REM活动度和强度及密度均降低,与治疗前比较均有显著性差异(P<0.05);治疗后阻滞组REM睡眠百分比及睡眠时间高于非阻滞组(P<0.01),余各指标治疗后两组间比较无明显差异(P>0.05)。相关分析显示,阻滞组和非阻滞组PSQI的变化率与所有PSG指标变化率均无显著相关性(P>0.05)。结论度洛西汀能延长阻滞性和非阻滞性抑郁症患者慢波睡眠,度洛西汀治疗后PSG和主观睡眠质量变化间可能并不存在相关性。Objective To investigate the effect of duloxetine on polysomnography and subjective sleep quality in rctardative depression and non-rctardative depression. Methods The 32 patients with depression without any medicine at least for 1 month were assessed in this study. Based on the scores of retardation of Hamilton Depression Scale（HAMD）, the patients were divided into the group of retardative depression and the group of non-retardative depression. All the subjects were received duloxetinc for 4 weeks, polysomnography and Pittsburgh sleep quality index （PSQI） were estimated at the begin and 4 weeks after treatments. Results There was no significant difference between retardative depression group and non-retardative depression group either before or after treatment on PSQI （P〉0.05）. The scores of PSQI both in two groups after treatment were lower than before （P〈0.05）. Compared with before, higher AN （awakening number） and A/TST% （the percentage of AT）, lower SE （sleep efficiency）, higher S1% （the percentage of I sleep）, higher SWS%, lower RT （REM sleep time） and RT% （the percentage of RT）, higher SL （sleep latency）, and lower RA （REM activity）, RI （REM intensity） and RD （REM density） were showed significant difference after treatment both in retardative depression group and non-retardative depression group （P〈0.05 or 0.01）. After treatment, except for RT and RT%（P〈0.05）, there were no significant difference between two groups（P〉0.05）. The correlation between the reduction rate of the PSQI total score and the change rate of all the PSG was not great（P〉0.05）. Conclusion Duloxetine could both extend the SWS （S3＋S4） in retardative depression and non-retardative depression. There is no relationship between the reduction rate of the PSQI total score and the Change rate of all the PSG parameters after treatment.

关 键 词：阻滞性抑郁症 非阻滞性抑郁症 度洛西汀 多导睡眠图 主观睡眠质量 

分 类 号：R395[哲学宗教—心理学]