文拉法辛、艾司西酞普兰对抑郁症患者痛觉诱发电位P250的影响  

Effects of venlafaxine and escitalopram on electrical pain-related evoked potentials P250 in depression:a control study

作　　者：纪菊英[1] 潘园园[1] 徐乐平[1] 李宁[1] 孙剑[1] 

机构地区：[1]解放军第102医院精神科,常州213003

出　　处：《临床精神医学杂志》2012年第5期322-325,共4页Journal of Clinical Psychiatry

摘　　要：目的:探讨不同作用机制的抗抑郁药文拉法辛、艾司西酞普兰对抑郁症患者电刺激痛觉诱发电位P250的影响。方法:52例抑郁症患者随机分组,分别接受文拉法辛(26例,75～225mg/d)、艾司西酞普兰(26例,10～20mg/d)治疗,于治疗前、治疗后2周末测定电刺激痛觉诱发电位P250,评定17项汉密尔顿抑郁量表(HAMD)。结果:文拉法辛组治疗前P250波幅为(33±10)μV,治疗后下降为(27±7)μV,差异有统计学意义(P=0.000);西酞普兰组治疗前P250波幅为(35±8)μV,治疗后为(34±9)μV,差异无统计学意义(P=0.091);两组治疗前后P250峰潜伏期差异均无统计学意义(P=0.417、0.562)。文拉法辛组治疗后的P250波幅下降率为(18±11)%,高于艾司西酞普兰组的(3±7)%,差异有统计学意义(P=0.000)。两组治疗后HAMD减分率分别为(24±4)%、(26±5)%,差异无统计学意义(P=0.166)。文拉法辛组、艾司西酞普兰组P250波幅下降率与HAMD减分率相关均无统计学意义(r=0.233,P=0.291;r=0.266,P=0.198)。结论:文拉法辛可下调抑郁症患者电刺激痛觉诱发电位P250波幅,其作用强于艾司西酞普兰、并可能独立于抗抑郁效应。Objective：To explore the effects of antidepressants with distinct pharmacological property venlafaxine and escitalopram on electrical pain-related evoked potentials P250 in major depression.Method：52 inpatients with depression were randomly divided into two groups treated by venlafaxine extended release （75～225 mg/d,n=26） or escitalopram （10～20 mg/d,n=26）.Pain-related evoked potentials measurement and 17-items Hamilton depression rating scale （HAMD） were conducted before and after two week treatment.Results：The amplitudes of P250 were significantly reduced after venlafaxine treatment[（33±10）μV vs（27±7）μV,P=0.000] while the difference was not significant before and after escitalopram treatment[（35±8）μV vs （34±9）μV,P=0.098].The averaged delta ratio of P250 amplitudes was significant higher in venlafaxine group than that in escitalopram group[（18±11）% vs （3±7）%,P=0.000].The differences of peak potential were not significant pre-and post-treatment in both two groups （P=0.417,0.562）.The reduction ratio of HAMD in venlafaxine group was not significantly different from that in escitalopram group[（24±4）% vs （26±5）%,P=0.166].There were no correlations between delta ratio of P250 amplitudes and that of HAMD in both two groups （r=0.223,0.266;P=0.291,0.198）.Conclusion：Venlafaxine may have stronger effects on down-regulating P250 amplitude than escitalopram and independent of antidepressant effects.

关 键 词：文拉法辛 艾司西酞普兰 诱发电位 痛觉 抑郁症 

分 类 号：R749.053[医药卫生—神经病学与精神病学]