艾司西酞普兰对抑郁症患者凝血功能的影响  

Effects of escitalopram on coagulation function in depression patients

作　　者：沈仲夏[1] 章晓梅[1] 蔡敏[1] 耿松[1] 张振[2] 杨胜良[1] 沈鑫华[1] Shen Zhongxia;Zhang Xiaomei;Cai Min;Gen Song;Zhang Zhen;Yang Shengliang;Shen Xinhua(Department of Psychosomatic Disorders, the Third People＇s Hospital of Huzhou City, Zhejiang Province, Huzhou 313000, China （ Shen ZX, Zhang XM, Cai M, Geng S, Yang SL, Shen XH;Clinical Laboratory, the Third People＇s Hospital of Huzhou City, Zhejiang Province, Huzhou 313000, China （ Zhang Z)

机构地区：[1]湖州市第三人民医院心身障碍科,浙江湖州313000 [2]湖州市第三人民医院检验科,浙江湖州313000

出　　处：《药物不良反应杂志》2018年第2期117-121,共5页Adverse Drug Reactions Journal

基　　金：浙江省医药卫生科技计划项目（2016KYB282）,湖州市公益性技术应用研究项目（2014GY16）

摘　　要：目的 探讨艾司西酞普兰对抑郁症患者凝血功能的影响. 方法 研究设计为前瞻性自身对照研究,研究对象选自2016年6月1日至2017年6月1日在湖州市第三人民医院心身科就诊和住院的抑郁症患者[汉密尔顿抑郁量表（HAMD）评分〉17分].符合入选标准的患者接受艾司西酞普兰治疗（起始剂量为5 mg/d,2周内加至10～20 mg/d）.治疗前及治疗第4周末分别行HAMD评分（HAMD评分减分率≥50%为有效）和凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）含量检测. 结果 共95例患者完成4周艾司西酞普兰治疗,其中男性38例,年龄21～64岁,平均（39 ± 12）岁;病程14～60个月,平均（32 ± 12）个月;女性57例,年龄20～64岁,平均（38 ± 13）岁;病程12～54个月,平均（28 ± 12）个月.治疗第4周末HAMD评分较治疗前显著下降[（9.1 ± 3.3）分比（21.8 ± 3.4）分,t=26.125,P〈0.001],PT、APTT、TT均较治疗前明显升高[（11.14 ± 1.22）s比（11.66 ± 1.41）s,（29.45 ± 5.24）s比（31.28 ± 5.64）s,（20.32 ± 2.08）s比（21.15 ± 2.21）s,均P〈0.05],FIB含量较治疗前显著下降[（1.92 ± 0.28）g/L比（2.01 ± 0.34）g/L, P〈0.05].不同性别患者凝血功能各项指标差异无统计学意义（P〉 0.05）,治疗后女性患者PT、TT增加值和FIB下降值显著高于男性患者（均P〈0.05）.治疗后有效组患者（80例）PT、TT、APTT增加值以及FIB下降值与无效组患者（15例）比较差异均无统计学意义（均P〉0.05）.有1例24岁女性患者经艾司西酞普兰15 mg/d治疗1个月余后出现上消化道出血. 结论 艾司西酞普兰对抑郁症患者的凝血功能有一定影响,对女性患者影响更为明显,有增加出血的风险.Objective To explore the effects of escitalopram on coagulation function in depression patients. Methods This was a self-controlled prospective study. The subjects were depression patients （Hamilton Depression Scale（HAMD）score〉17）who presented to or hospitalized in the Department of Psychosomatic Disorders in the Third People′s Hospital of Huzhou City from June 1,2016 to June 1,2017. The patients in accordance with inclusion criteria were treated with escitalopram（initial dose was 5 mg/d and increased to 10-20 mg/d within 2 weeks）. HAMD rating scale were performed,prothrombin time （PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）and fibrinogen（FIB）were detected before treatment and 4 weeks after treatment. Response was defined as a 50% reduction in HAMD score. Results A total of 95 patients finished the 4 weeks treatment with escitalopram. Of them,38 patients were male with ages from 21 to 64 years and mean age of（39 ± 12）years,with illness duration from 14 to 60 months and mean illness duration of（32 ± 12）years;57 cases were female with ages from 20 to 64 years and mean age of（38 ± 13）years,with illness duration from 12 to 54 and mean illness duration of （28 ± 12）years. HAMD score were（21.8 ± 3.4）and（9.1 ± 3.3）before and after 4 weeks treatment, respectively（t=26.125,P〈0.001）. The levels of PT,APTT,and TT in patients after 4 weeks treatment were significantly higher than those before treatment[（11.14 ±1.22）s vs.（11.66 ±1.41）s,（29.45 ± 5.24）s vs.（31.28 ± 5.64）s,（20.32 ± 2.08）s vs.（21.15 ± 2.21）s,respectively,all P〈0.05]. However, the FIB level after 4 weeks treatment was significantly decreased than that before treatment[（1.92 ± 0.28） g/L vs.（2.01 ± 0.34）g/L,P 〈0.05]. There were no significant differences among the indexes of coagulation function among the patients with different sex（P〉0.05）. After treatment,the increased values of PT and TT levels and the decreased value of FIB l

关 键 词：西酞普兰 抑郁症 血液凝固 

分 类 号：R749.4[医药卫生—神经病学与精神病学]