西酞普兰对共病糖尿病的抑郁症患者的临床疗效研究  

Clinical Effect Study on Citalopram in Major Depression Patients with Diabetes

作　　者：任会鹏[1] 王学义[1] 宋美[1] 刘小玉[1] 王小敏[1] 史少霞[1] 王金成[1] 王岚[1] 

机构地区：[1]中国．河北医科大学第一医院精神卫生研究所,河北省脑老化与认知神经科学重点实验室,石家庄050031

出　　处：《中国健康心理学杂志》2011年第9期1033-1035,共3页China Journal of Health Psychology

摘　　要：目的探讨抑郁症与糖尿病共病后的治疗反应以及疗效与血糖的关系。方法研究对象为2006年1月-2008年1月在河北医科大学精神卫生研究所住院的抑郁症患者,其中抑郁症合并2型糖尿病患者28例,设为共病组;配对抽取未合并糖尿病的抑郁症患者17例,为非共病组。疗前采用17项汉密尔顿抑郁量表(Hamilton Depression Rating Scale 17,HAMD-17)评定抑郁的严重程度。随后对两组患者采用西酞普兰片(喜普妙)进行治疗,治疗剂量和疗程均相同,治疗后采用HAMD减分率评价两组疗效。并检测共病组疗后的HbA1c水平,按照HbA1c水平再将共病组分为HbA1c达标组(HbA1c<6.5%,n=18)和HbA1c不达标组(HbA1c≥6.5%,n=10)2个亚组,并对2个亚组的疗效和其他指标进行比较。结果 1治疗后共病组HAMD减分率明显低于非共病组(t=-5.049,P<0.01);2共病组中HbA1c达标组和HbA1c不达标组相比,达标组疗前HbA1c水平较低,达标组HAMD减分率明显低于非达标组,差异有统计学意义(t=5.016,P<0.01)。结论抑郁症与糖尿病共病患者抗抑郁治疗的效果明显差于非共病组,血糖控制不良的共病患者疗前的血糖水平较高,同时该组患者抗抑郁的疗效不佳。Objective To explore the treatment effect of depression with type 2 diabetes and the relation to blood sugar.Methods The depression patients from the Mental Health Institute of Hebei Medical University hospitalized from January,2006 to January 2008 were included in our study,28 cases of patients with depression and diabetes were as comorbid group,and 17 cases with depression but without diabetes were as non-comorbid group.During the hospitalization,we used Hamilton Depression Rating Scale 17（HAMD-17） to assess the severity of depressive symptoms,soon,all the patients were administrated with Citalopram（Cipramil） at the same dosage and course of treatment.The treatment effects were assessed by HAMD minus rate between two groups.The levels of HbA1c were tested after treatment.The comorbid group was divided into two subgroups according to HbA1c levels after treatment：standard HbA1c group（HbA1c6.5%,n=18） and non-standard HbA1c group（HbA1c≥6.5%,n=10）,then the therapeutic effects of two subgroups were compared.Results ①After treatment,the HAMD minus ratio of comorbid group was less than that of non-comorbid group（t=-5.049,P0.01）.②In comorbid group,compared to non-standard HbA1c group,the HbA1c level of standard HbA1c group was lower than that before treatment.The recovery rate of standard HbA1c group was obviously higher than that of non-standard HbA1c group and there were differences between two subgroups（t=5.016,P0.01）.Conclusion Worse treatment response is found in patients with comorbid depression and type 2 diabetes,compared with non-comorbid group.There are not good therapeutic effects in comorbid patients with worse controlled blood sugar.

关 键 词：抑郁症 2型糖尿病 对照研究 汉密尔顿抑郁量表 

分 类 号：R587.1[医药卫生—内分泌]