舍曲林与万拉法辛治疗双相障碍抑郁发作患者认知功能相关性研究  

Relevant research of sertraline and venlafaxine in treating cognitive function in patients with bipolar depressive disorder

作　　者：王增旋 张程赪 

机构地区：[1]粤北第三人民医院,广东乐昌512200

出　　处：《现代医药卫生》2013年第5期662-664,666,共4页Journal of Modern Medicine & Health

基　　金：广东省韶关市卫生医药科研资助项目(Y13214)

摘　　要：目的比较舍曲林与万拉法辛治疗双相障碍抑郁发作患者对认知功能的影响及其相关性研究。方法将100例双相障碍抑郁发作的门诊或住院患者,按照随机数字表法分为舍曲林组和万拉法辛组,各50例,治疗12周,可联合应用心境稳定剂。在治疗基线与治疗末评估汉密尔顿抑郁量表17项(HAMD17)、中国修订韦氏成人智力量表(WAIS-RC),并进行威斯康星卡片分类测验(WCST)、Stroop字色测验(Stroop)等。结果两组患者治疗后,HAMD17评分及神经心理学测验成绩较治疗前显著改善,差异有统计学意义(P<0.05)。认知功能的相关因素分析显示,治疗后HAMD17总分减分值与Stroop中卡片C-字错误数呈正相关(P<0.05),体质量因子减分值与Stroop中SIE错误数1改变量呈正相关(P<0.05),认识障碍减分值与WCST中完成分类数、总应答数、持续错误数、非持续错误数、概念化水平和Stroop中卡片C-色错误数呈正相关(P<0.05)。结论舍曲林与万拉法辛均能改善双相障碍抑郁发作患者的认知功能,表现在注意力、执行能力、智力等方面,且认知功能的改善与抑郁症状的缓解具有相关性。Objective To compare the influence of sertraline and vanrafasin on the cognitive function in the patients with bipolar depressive disorder,and to perform the relevant research. Methods 100 outpatients or inpatients with bipolar de- pressive disorder were randomly derided into the sertraline group and the venlafaxine group according to the random number table ,50 cases in each group. The treatment lasted for 12 weeks,and could be combined with the mood stabilizers. The 17 items in the Hamilton Depression Scale （HAMD17） and the neuropsychological assessments （WAIS-RC, WCST, Stroop）were valuated at the baseline and the end of treatment. Results The HAMD17 score and the neuropsychological tests scores after treatment were significantly improved with statistical significance in the difference between the two groups （P〈0.05）. The analysis of the cognitive function related factors showed that there was positive correlation between HAMD17 toatal reduced value and the Stroop card-C error after treatment （P〈0.05） ;there was positive correlation between the reduction of BMI and the variation of SIE error （P〈0.05） ;there was positive correlation between the reduction of cognitive disturbance with the complete categories of WCST, total answering number,persistent errors,non-persistent errors,conceptualization and Stroop card-C errors（P〈0.05）. Conclusion Sertraline and vanrafasin can improve the cognitive function in the patients with bipolar depressive disorder, including attention, executive capacity and intelligence. The improvement of cognitive function has the correlation with the relief of depressed symp- toms.

关 键 词：双相情感障碍 药物疗法 认知 舍曲林 治疗应用 环己醇类 治疗应用 抗抑郁药 第二代 治疗 应用 万拉法辛 

分 类 号：R749.16[医药卫生—神经病学与精神病学]