艾司西酞普兰与氟西汀对抑郁症患者疗效及血清脑源性神经营养因子、炎性反应因子的影响  

Effects of escitalopram and fluoxetine on depression and serum BDNF and inflammatory reaction factor

作　　者：金玲 Jin Ling(Anshan Mental Health Center,Anshan 114000,China)

机构地区：[1]辽宁省鞍山市精神卫生中心,114000

出　　处：《神经疾病与精神卫生》2019年第7期692-696,共5页Journal of Neuroscience and Mental Health

摘　　要：目的分析艾司西酞普兰与氟西汀治疗抑郁症患者临床疗效及对患者血清脑源性神经营养因子(BDNF)、炎性反应因子的影响.方法以2017年1月至2018年11月在我院精神科收治的抑郁症患者118例为研究对象,按照随机数字表法分为观察组59例和对照组59例,对照组患者采用氟西汀治疗,观察组采用艾司西酞普兰治疗,两组均治疗6周,观察治疗后两组临床疗效,比较治疗前后两组血清BDNF、神经功能相关因子(S100B)及炎性反应因子[白细胞介素2、6(IL-2、IL-6)、肿瘤坏死因子α (TNF-α)]水平的变化,记录治疗前后汉密顿抑郁量表(HAMD)评分和不良反应量表(TESS)评分变化.结果观察组经艾司西酞普兰治疗后总有效率为86.44%,对照组经氟西汀治疗后总有效率为76.27%,两组比较差异无统计学意义(χ2=2.011,P>0.05);两组治疗后血清BDNF水平与治疗前相比明显升高, S100B水平下降(P<0.01),观察组治疗后血清BDNF水平明显高于对照组(P<0.01),而S100B水平明显低于对照组(P<0.01).两组治疗后IL-2、IL-6、TNF-α水平与治疗前相比明显降低,观察组治疗后各炎性因子水平明显低于对照组(P<0.01).治疗3周、6周后两组HAMD评分与治疗前相比均明显降低(P<0.01),在治疗3周后观察组HAMD评分明显低于对照组(P<0.01),在治疗6周后两组HAMD评分比较差异无统计学意义(P>0.05),观察组治疗期间TESS评分略低于对照组,但差异无统计学意义(P>0.05).结论艾司西酞普兰与氟西汀治疗抑郁症均具有显著疗效,且安全性相当,相较于氟西汀,艾司西酞普兰治疗后患者血清BDNF明显升高,炎性因子水平明显降低,且起效快.Objectives To analyze the clinical efficacy of escitalopram and fluoxetine in the treatment of depression and the influence on serum brain-derived neurotrophic factor (BDNF) and inflammatory response factor. Methods A total of 118 patients with depression admitted to the psychiatric department of our hospital from January 2017 to November 2018 were recruited as the research subjects. All the subjects were assigned to observation group (n=59) and control group (n=59) by random number table method. The control group was treated with fluoxetine, while the observation group was treated with escitalopram. The treatment lasted for 6 weeks. The clinical effects of the two groups were observed after treatment, and the two groups were compared before and after on serum levels of BDNF, neurological function-related factor (S100B) and inflammatory reaction factors, including interleukin-2, 6 (IL-2, IL-6) and tumor necrosis factor-alpha (TNF-α). The changes of Hamilton Depression Scale (HAMD) score and Treatment Emergent Symptom Scale (TESS) score were recorded before and after treatment. Results The total effective rate was 86.44% in the observation group and 76.27% in the control group. There was no statistical significance in the difference between the two groups (P> 0.05). After treatment, the level of serum BDNF increased significantly than before, while the level of S100B decreased (P<0.01). The level of BDNF of the observation group is higher than that of the control group, while the level of S100B is lower after treatment (P<0.01). After treatment, the levels of IL-2, IL-6 and TNF-α in the two groups were significantly lower than those before treatment. The levels of inflammatory factors in the observation group after treatment were significantly lower than those in the control group (P<0.01). After 3 and 6 weeks of treatment, HAMD scores in both groups were significantly lower than those before treatment (P<0.01). The HAMD score of the observation group was significantly lower than that of the control group after

关 键 词：抑郁症 艾司西酞普兰 氟西汀 脑源性神经营养因子 炎性反应因子 

分 类 号：R74[医药卫生—神经病学与精神病学]