摘要
目的探讨抗抑郁治疗的早期疗效能否有效预测治疗效果。方法 138例抑郁障碍患者,符合国际疾病分类第10版(ICD-10)精神与行为障碍分类系统中中重度抑郁发作、中重度复发性抑郁障碍或双相情感障碍重度抑郁发作的诊断标准,用汉密顿抑郁量表(HAMD)评定疗效。根据治疗1周后HAMD减分率是否大于25%,将研究病例分为早期治疗反应组和早期治疗无反应组。采用末次观察推进法弥补缺省值。结果 (1)意向分析结果表明,经过住院抗抑郁治疗后评估期末两组患者治疗均有效(F1=215.98,P=0.000),但早期反应组治疗效果好于早期治疗无反应组(F2=16.47,P=0.000)。(2)治疗早期反应组痊愈率59.2%(61例)远高于治疗早期无反应组20%(7例)(χ2=16.03,P=0.000)。(3)早期反应组住院时间短于早期无反应组(30.7±13.2∶68.9±14.8;t=2.92,P=0.004)。(4)治疗早期无反应组男性比例高于早期反应组(71.4%∶41.7%;χ2=9.27,P=0.002)。结论抗抑郁治疗1周时的HAMD评分变化是治疗5周末疗效的一个重要预测指标,早期治疗反应愈好,终末疗效越好。
Objective To explore the significance of earlier effect on clinical outcome in the treatment of inpatients with depressive disorders. Methods A total of 138 patients with depressive disorder met the criteria of ICD - 10 were assessed with the HAMD. The patients were invivided into two groups, according the reduction rate of HAMD score at 1 st weekend was larger than 25% or not, earlier response group and earlier non - response group. The statisical analysis was used last observation carried forward. Results （ 1 ） The outcome of ITr showed all the inpatients in the two groups had singnificant improvement （F1 = 215.98, P = 0. 000）, but the effectiveness in the earlier response group was signifi- cantly better than that in the earlier non -response group （F2 = 16.47,P = 0. 000）. （2） Based on the total score of HAMD at the final point, the remission rate in earlier response group was significantly higher than that in the earlier non - response group （59.2% ： 20.0% ; x2 = 16.03, P = 0. 000）. （3） The duration of hospitalizetion in the earlier response group was significantly shorter than that in the earlier non - responsed group （ 30. 668.9 ± 13.2：68.9 ± 14.8 ; t = 2.92, P = 0.004）. （4） The propol^ion of male inpatients in the earlier non - response group was significantly higher than that in the earlier response group （71.4%： 41.7% ;X2 =9.27 ,P = 0.002）. Conclusion The change of HAMD score at I st weekend is an important indicator of subsequent remission of 5 week antidpressive therapy.
出处
《精神医学杂志》
2010年第4期262-264,共3页
Journal of Psychiatry
关键词
抑郁障碍抗抑郁治疗
早期反应
Depressive disorder Antidepressive therapy Earlier response
