不同剂量喹硫平联合丙戊酸镁对青少年双相情感障碍抑郁发作患者疗效及血清TSH、PRL、DA水平的影响  

Effect of Different Doses of Quetiapine Combined with Magnesium Valproate on Efficacy and Serum TSH,PRL and DA Levels in Adolescent Bipolar Disorder Patients with Depressive Episodes

作　　者：刘晓燕 敖玲 郭洋达 陈腊梅 LIU Xiaoyan;AO Ling;GUO Yangda;CHEN Lamei(Department of Psychiatric,Jiangxi Mental Hospital,Nanchang 330029,China;不详)

机构地区：[1]江西省精神病院精神科,江西南昌330029

出　　处：《中国医学创新》2024年第22期129-133,共5页Medical Innovation of China

摘　　要：目的:分析不同剂量喹硫平联合丙戊酸镁对青少年双相情感障碍(BPD)抑郁发作疗效,以及血清促甲状腺激素(TSH)、催乳素(PRL)、多巴胺(DA)水平的影响。方法:前瞻性选取2021年3月—2022年3月于江西省精神病院治疗的BPD抑郁发作的120例青少年,采用随机数字表法将患者分为低剂量组、高剂量组,各60例。低剂量组给予采用低剂量的喹硫平联合丙戊酸镁治疗,高剂量组采用高剂量的喹硫平联合丙戊酸镁治疗(n=60)。比较两组治疗效果、贝克-拉范森躁狂量表(BRMS)评分、汉密尔顿抑郁量表(HAMD)评分、血清TSH、PRL、DA水平及不良反应发生情况。结果:两组的总有效率比较,差异无统计学意义(P>0.05)。治疗后,两组HAMD评分均较治疗前显著降低,差异均有统计学意义(P<0.05),两组组间比较,差异无统计学意义(P>0.05)。治疗前后,两组BRMS评分比较,差异均无统计学意义(P>0.05)。治疗后,低剂量组的TSH、PRL、DA水平较治疗前差异均无统计学意义(P>0.05);高剂量组TSH、PRL、DA水平较治疗前升高,差异均有统计学意义(P<0.05),且高剂量组均高于低剂量组,差异均有统计学意义(P<0.05)。高剂量组的不良反应发生率高于低剂量组,差异有统计学意义(P<0.05)。结论:喹硫平联合丙戊酸镁对BPD抑郁发作的青少年患者有显著的疗效,能有效降低患者抑郁发作程度,且低剂量的喹硫平对血清TSH、PRL、DA水平无明显影响,安全性更高。Objective:To analyze the effects of different doses of Quetiapine combined with Magnesium Valproate on adolescent bipolar disorder(BPD)with depressive episodes and serum thyroid stimulating hormone(TSH),prolactin(PRL),dopamine(DA)levels.Method:A total of 120 adolescent with BPD with depression episodes treated in Jiangxi Mental Hospital from March 2021 to March 2022 were prospectively selected,were divided into a low-dose group and a high-dose group by random number table method,with 60 cases in each group,low-dose group was treated with low-dose Quetiapine combined with Magnesium Valproate,and the high-dose group was treated with high-dose Quetiapine combined with Magnesium Valproate.Efficacy,Bech-Rafaelsen mania rating scale(BRMS)score,Hamilton depression scale(HAMD)score,serum TSH,PRL,DA levels,and incidence of adverse reactions were compared.Result:There was no significant difference in the total effective rate in two group(P>0.05).After treatment,HAMD scores in both groups were decreased compared to those before treatment,the differences were statistically significant(P<0.05);there was no statistically significant difference between the two groups(P>0.05).Before and after treatment,there were no statistically significant differences in BRMS scores between the two groups(P>0.05).After treatment,the levels of TSH,PRL and DA in the low-dose group compared to those before treatment,the differences were not statistically significant(P>0.05);the levels of TSH,PRL and DA in the high-dose group were significantly increased than those before treatment,the differences were statistically significant(P<0.05),and the high-dose group was higher than those in the lowdose group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the high-dose group was higher than that in the low-dose group,the difference was statistically significant(P<0.05).Conclusion:Quetiapine combined with Magnesium Valproate has significant efficacy in adolescent patients with BPD with depression episodes,and c

关 键 词：喹硫平 促甲状腺激素 丙戊酸镁 抑郁发作 催乳素 双相情感障碍 多巴胺 

分 类 号：R749.4[医药卫生—神经病学与精神病学]