米氮平与舍曲林治疗首发抑郁症效果及对血清脑源性神经营养因子影响的比较  

The Comparison of Efficacy of Mirtazapine and Sertraline in the Treatment of First-episode Depression and the Effect of Serum Brain-derived Neurotrophic Factor

作　　者：王福华 寇海燕 WANG Fu-hua KOU Hai-yan(Binzhou Youfu Hospital, Binzhou 256600, Chin)

机构地区：[1]山东省滨州市优抚医院,山东滨州256600

出　　处：《中国医学创新》2017年第6期101-104,共4页Medical Innovation of China

摘　　要：目的:探讨米氮平与舍曲林治疗首发抑郁症的临床效果以及对血清脑源性神经营养因子(brain-derived neurotrophic factory,BDNF)含量的影响。方法:将174例首发抑郁症患者按就诊顺序分成两组,每组87例,分别口服米氮平和舍曲林治疗,观察8周。比较治疗前后的临床疗效和不良反应,同时检测血清BDNF水平的变化。结果:治疗后,两组的HAMD评分均较治疗前显著下降(P<0.01),米氮平组治疗第1、2周末均较舍曲林组下降更显著(P<0.05),治疗第8周末,米氮平组总有效率为90.8%,舍曲林组为88.5%,两组比较差异无统计学意义(P>0.05)。两组的不良反应均较轻微,两组的性功能障碍、睡眠障碍、体重增加发生率比较,差异均有统计学意义(P<0.05)。治疗前,两组血清BDNF水平均低于正常值,治疗后两组血清BDNF水平均较治疗前呈持续性升高(P<0.05),米氮平组治疗第1周末显著高于舍曲林组(P<0.05),两组其他时点检测结果比较,差异均无统计学意义(P>0.05)。结论:米氮平与舍曲林治疗首发抑郁症效果显著且相当,但米氮平起效更快,不良反应较少;首发抑郁症患者发病期间血清BDNF水平均明显降低,经抗抑郁药物治疗后随着抑郁症状的改善,血清BDNF水平也逐渐升高。Objective： To investigate the clinical effect of Mirtazapine and Sertraline in treatment of depression and effect on serum brain-derived neurotrophic factor content.Method： 174 patients with first-episode depression were divided into two groups according to the order of treatment, each group of 87 cases, they were treated by oral administration of Mirtazapine and Sertraline, respectively, for a period of 8 weeks.The clinical efficacy and adverse reactions were compared before and after treatment, and the changes of serum BDNF levels were measured.Result： After treatment, the HAMD scores of the two groups were significantly lower than those before treatment （ P〈0.O1 ）, Mirtazapine group after the first and second week treatment were compared with sertraline group significantly decreased （ P〈O.05 ）, at the end of the eighth week total effective rate was respectively 90.8% in Mirtazapine group and 88.5% in Sertraline group, there was no significant difference between the two groups （ P〉O.05 ） .Adverse reaction of two groups was mild, but sexual dysfunction, sleep disorders, weight gain rate between two groups were different significantly （ P〈O.05 ） .Before treatment, the serum BDNF levels of the two groups were lower than the normal value, and the serum BDNF levels of the two groups after treatment were higher than those before treatment （ P〈O.05 ）, BDNF levels of Mirtazapine group was significantly higher than that of sertraline group at the end of the first week （ P〈O.05 ）, but there were no significant differences between both groups at other time points （P〉0.05） .Conclusion： Mirtazapine and Sertraline in the treatment of first-episode depression effect are obvious and quite, but Mirtazapine has a faster onset and less adverse reaction; the first-episode depression during the serum BDNF levels are decreased after antidepressant treatment with improvement of depressive symptoms, serum BDNF levels gradually increased.

关 键 词：脑源性神经营养因子 首发抑郁症 舍曲林 米氮平 

分 类 号：R749.4[医药卫生—神经病学与精神病学]