摘要
目的:探讨喹硫平联合伏硫西汀治疗难治性抑郁症的临床疗效及对患者睡眠脑电图、外周血脑源性神经营养因子(BDNF)水平等的影响。方法:选取2021年2月~2023年8月期间于某院治疗的94例难治性抑郁症患者作为研究对象,采用随机数字表法分为对照组(因擅自停药剔除1例)和观察组(因擅自加用其他抗抑郁药物剔除1例),最终每组均纳入46例。对照组患者给予氢溴酸伏硫西汀片治疗,观察组患者在对照组治疗基础上加用富马酸喹硫平片。比较两组患者临床疗效、威斯康星卡片分类测验(WCST)评分、外周血BDNF相关因子[BDNF、BDNF前体(proBDNF)、成熟型BDNF(mBDNF)、酪氨酸激酶受体B(TrkB)]、睡眠脑电图参数[睡眠潜伏期、觉醒次数、觉醒时间、睡眠总时间、睡眠效率]及不良反应发生情况。结果:治疗后,观察组患者治疗总有效率(89.13%)高于对照组(71.74%,P<0.05);两组患者持续错误数、随机错误数、proBDNF水平、睡眠潜伏期、觉醒次数和觉醒时间均降低,且观察组低于对照组(P<0.05);正确数、BDNF水平、mBDNF水平、TrkB水平、睡眠总时间和睡眠效率均升高,且观察组高于对照组(P<0.05)。治疗期间,两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:喹硫平联合伏硫西汀治疗难治性抑郁症患者临床疗效较佳,可显著改善睡眠脑电图,调节BDNF相关因子,且未增加不良反应的发生风险。
Objective:To investigate the clinical efficacy of quetiapine combined with vortioxetine in the treatment of treatment-resistant depression and its effects on sleep electroencephalogram and brain-derived neurotrophic factor(BDNF)level of patients.Methods:A total of 94 patients with treatment-resistant depression treated in a hospital from February 2021 to August 2023 were selected and assigned to the control group(with 1 patient excluded due to unauthorized drug discontinuation)and the observation group(with 1 patient excluded due to unauthorized addition of other antidepressants)using a random number table method,resulting in 46 patients enrolled in each group.Patients in the control group was treated with vortioxetine hydrobromide tablets,while patients in the observation group was treated with quetiapine fumarate tablets on the basis of control group.The clinical efficacy,Wisconsin card sorting test(WCST)score,peripheral blood BDNF-related factors[BDNF,BDNF precursor(proBDNF),mature BDNF(mBDNF),tyrosine kinase receptor B(TrkB)],sleep electroencephalogram parameters[sleep latency,awakening frequency,awakening time,total sleep time,sleep efficiency]and adverse reactions were compared between the two groups.Results:After treatment,the total effective rate in the observation group(89.13%)was higher than that in the control group(71.74%,P<0.05).The number of perseverative errors,random errors,proBDNF level,sleep latency,awakening frequency and awakening time were decreased in both groups,with the observation group showing lower values than those in the control group(P<0.05).The number of correct responses,BDNF level,mBDNF level,TrkB level,total sleep time and sleep efficiency were increased in both groups,with the observation group showing higher values than those in the control group(P<0.05).During the treatment period,no statistically significant difference in the total incidence of adverse reactions was observed between the two groups(P>0.05).Conclusion:Quetiapine combined with vortioxetine shows better clinical
作者
张进周
王彦辉
ZHANG Jin-zhou;WANG Yan-hui(Department of Psychiatry,Pingdingshan Psychiatric Hospital,Pingdingshan 467036,China)
出处
《中国合理用药探索》
CAS
2024年第9期57-62,共6页
Chinese Journal of Rational Drug Use
关键词
喹硫平
伏硫西汀
难治性抑郁症
睡眠脑电图
疗效
脑源性神经营养因子
quetiapine
vortioxetine
treatment-resistant depression
sleep electroencephalogram
efficacy
brain-derived neurotrophic factor
