低剂量奥氮平抗抑郁增效作用及对自主神经功能影响的对照研究  

A case-control study of low-dose olanzapine antidepressant synergy effect and the influence of autonomic nervous function

作　　者：张付全[1] 王军[1] 王国强[1] 

机构地区：[1]江苏省无锡市精神卫生中心,214151

出　　处：《临床精神医学杂志》2017年第1期41-43,共3页Journal of Clinical Psychiatry

基　　金：无锡市医院管理中心重点研究项目(YGZXZ1507);无锡市科技发展指导性计划项目(CSZ0N1517)

摘　　要：目的:探讨低剂量奥氮平对5-羟色胺再摄取抑制剂(SSRIs)抗抑郁的增效作用及对抑郁障碍(MDD)患者心血管的安全性。方法:61例MDD患者随机分为研究组(29例)和对照组(32例),两组在SSRI治疗的基础上,研究组联合奥氮平5 mg/d;疗程均为4周。治疗前后进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定及心率变异性(HRV)分析。结果:1治疗后两组HAMD及HAMA评分较治疗前显著降低(P均<0.01),且研究组HAMA评分显著低于对照组(P<0.01);两组间治疗前HAMD评分及治疗前后HAMD评分比较差异无统计学意义。2治疗后两组HRV指标中的正常RR间期标准差(SDNN)及高频功率(HF)显著升高(P均<0.05),低频功率(LF)治疗前后差异无统计学意义;两组间HRV各项指标比较差异无统计学意义。结论:低剂量奥氮平对SSRIs具有一定的抗抑郁增效作用,短期使用对血管安全性没有影响。Objective： To explore the low-dose olanzapine antidepressant synergy effect for selective se- rotonin reuptake inhibitors （SSRIs） and the influence of autonomic nervous function in patients with major depressive disorder （MDD）. Method： Sixty-one MDD patients were randomly divided into syudy group （29 ca- ses） and control group（32 cases） . On the basis of SSRI treatment in both groups,the syudy group was combined with low-dose olanzapine （5 mg/d）. The course in both groups was 4 weeks. Before and after treatment the patients were evaluated with Hamilton depression scale （HAMD）, Hamilton anxiety scale （HAMA） and analyzed with heart rate variability （HRV）. Results：（1） The scores of HAMA and HAMD in the two groups af- ter treatment were significantly reduced than before treatment （all P 〈0.01 ） ;and score of HAMD in the study grouo was significantly lower than the control group（ P 〈 0.01 ）. Between the two groups, the HAMD scores at before treatment and HAMD scores before and after treatment there were no statistically significant difference. （2） In the two groups after treatment, the indices of HRV in the normal period of standard deviation between the RR （SDNN） and high frequency power （HF） were increased significantly （ all P 〈 0.05 ） ; the low frequency power （LF） there was no statistically significant difference before and after treatment. The difference of HRV indica- tors between the two group had no statistical significance. Conclusion：Low-dose olanzapine has certain antidepressant synergistic effect for SSRIs ; and short-term use has no effect on the safety of blood vessels.

关 键 词：抑郁症 心率变异性 奥氮平 5-羟色胺再摄取抑制剂 

分 类 号：R749.4[医药卫生—神经病学与精神病学]