摘要
目的探讨帕罗西汀、文拉法辛、阿米替林对首发抑郁症认知功能的影响。方法选择在我院住院的首发抑郁症患者120例,随机分为三组:A组、B组、C组,分别给予帕罗西汀、文拉法辛、阿米替林治疗,在治疗前、治疗8周末、随访1年末,采用数字划销测验(NCT)、修订韦氏成人记忆量表(WMS-RC)、威斯康星卡片分类测验(WCST)进行注意力、记忆功能、执行功能测定。结果治疗前、治疗8周和随访1年后HAMD总分差异无显著意义(P>0.05);治疗8周、1年时TESS评分,A组与B组差异无显著意义(P>0.05),A组与C组、B组与C组之间差异有显著意义(P<0.05);治疗8周、1年时与治疗前比较,三组NCT中的净分、失误率及WMS-RC的记忆商数均改善(P<0.05),WCST的总测验次数、持续错误数、随机错误数均下降(P<0.05);治疗8周、1年时净分、失误率、WMS-RC的记忆商数、WCST的总测验次数、持续错误数、随机错误数三组之间的差异均有显著意义(均P<0.05),但A组与B组之间差异无显著意义(P>0.05);1年时,三组的失误率下降值、记忆商增加值、净分增加值、总测验次数下降值、持续错误数下降值、随机错误数下降值均与HAMD减分值呈正相关(P<0.05),与TESS评分呈负相关(P<0.05)。结论帕罗西汀、文拉法辛、阿米替林均可以改善抑郁症的认知功能,但阿米替林的抗胆碱能作用明显影响了认知功能改善程度。
Objective To compare the effect of paroxetine, venlafaxine and amitriptyline on cognitive function in patients with first episode depression. Methods A total of 120 patients with first episode depression were randomized into three groups treated with paroxetine （ n = 40）, venlafaxine （ n = 40） and amitriptyline （ n = 40） for 1 year. Number Cancellation Test （ NCT）, Wechsler Memory Scale - revised （ WMS - RC ） and Wisconsin Card Sorting Test （WCST） were used at baseline, 8th weekend and the endpoint of treatment to assess the cognitive function. Results There was no significant difference in score of HAMD at the three interview - points among three groups （ P 〉 0.05 ）. Score of TESS showed no significant difference between paroxetine group and venlafaxine group （ P 〉 0.05 ） at the 8th weekend and the endpoint of treatment, while there was significant difference between paroxetine group and amitriptyline group （P 〈 0.05 ）, as well as between venlafaxine group and amitriptyline group （ P 〈 0.05 ）. Compared with the baseline, net score and error rate of NCT, and memory quotient of WMS - RC improved significantly in all the three groups at the gth weekend and the endpoint of the treatment （ P 〈 0.05 ）, as well as scores of WCST such as total testing times, continuing mistakes, random mistakes （P 〈 0.05）. At the 8th weekend and the endpoint of the treatment, there were significant differences among the three groups on net score and error rate of NCT, memory quotient of WMS - RC, total numbers of tests, continuous errors, and random errors of WCST （ P 〈 0.05 ）, but the significance vanished when compared between the paroxetine group and the venlafaxine group （ P 〉 0.05 ）. At the endpoint of the treatment, there was positive correlation between decreased score of HAMD, decreased score of error rate, increased score of memory quotient, increased net score, decreased score of the total number of tests, decreased score of continuous errors, decreased score of random errors （P 〈 0.05）. However, those parameters mentioned above were negatively correlated with score of TESS at the endpoint of treatment （P 〈 0.05 ）. Conclusion Paroxetine, venlafaxine and amitriptyline can improve cognitive function of first episode depressive patients, but anticholinergic effects of amitriptyline prohibited the improvement of cognitive function significantly.
出处
《精神医学杂志》
2011年第4期263-266,共4页
Journal of Psychiatry
基金
济宁市科技发展计划项目(项目编号:2009-38)
