氯胺酮对接受常规抗抑郁治疗患者疗效的影响  

The effects of ketamine on patients receiving general antidepression therapy

作　　者：胡春兰[1] 刘丰华[2] 王晓斌[2] 陈运良[2] 张涛[3] 

机构地区：[1]泸州医学院附属医院叙永医院麻醉科,泸州市646000 [2]泸州医学院附属医院麻醉科 [3]泸州医学院附属医院精神科

出　　处：《临床麻醉学杂志》2014年第9期848-850,共3页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(81271478)

摘　　要：目的探讨氯胺酮对接受常规抗抑郁治疗抑郁患者疗效的影响。方法采用随机、双盲设计,30例汉密尔顿抑郁评分(Hamilton depression rating score,HDRS)15分及以上、首次行常规抗抑郁治疗且不接受电休克治疗(electroconvulsive therapy,ECT)的抑郁症患者随机分为氯胺酮组和对照组,每组15例,分别静脉给予氯胺酮0.5mg/kg和等容积的生理盐水后接受常规抗抑郁治疗。评估两组患者治疗前(基础值)和治疗后8h、1、2、3和7d的HDRS及给药期间不良反应发生情况,并计算临床有效率。结果与治疗前比较,治疗后8h、1、2、3和7d氯胺酮组和治疗后1、2、3和7d对照组HDRS评分明显降低(P<0.05或P<0.01);与对照组比较,治疗后8h、1、2、3和7d氯胺酮组HDRS评分明显降低(P<0.05),临床有效率明显增加(P<0.05)。结论氯胺酮治疗可迅速改善常规抗抑郁治疗抑郁患者的抑郁症状。Objective To investigate the effects of ketamine on patients receiving general antidepression therapy.Methods Using a randomized,double-blind ed method,a totel of 30 depression patients（Hamilton depression rating score,HDRS≥15scores,first receiving general anti-depression therapy and refusing ECT therapy）were randomly assigned to the ketamine group and the control group（n=15each group）,which received intravenous injection of ketamine（0.5mg/kg）or saline（same volume）respectively.All patients received continuously general anti-depression therapy after ketamine or saline treatment.All patients’ s HDRS were judged before（baseline）and 8h,1,2,3,7d after intravenous injection of saline solution or ketamine,and adverse reactions were recorded during intravenous injection of ketamine or saline.The percent rate of clinically effective patients was recorded.Results Compared with baseline,HDRS in group ketamine 8h,1,2,3,7dafter treatment and in group control 1,2,3,7dafter treatment were decreased significantly（P〈0.05 or P〈0.01）.Compared with group control,HDRS in group ketamine 8h,1,2,3,7dafter treatment were decreased significantly（P〈0.05）.The percent rate of clinically effective patients at each point time in group ketamine was higher than that in group control（P〈0.05）.Conclusion Ketamine at sub-anesthesia dose can rapidly improve the symptoms of patients receiving general anti-depression treatment.

关 键 词：抑郁症 汉米尔顿抑郁量表 氯胺酮 

分 类 号：R749.4[医药卫生—神经病学与精神病学]