【摘要】 目的探讨米氮平对伴2型糖尿病抑郁障碍患者血脂代谢的影响。方法将90例伴糖尿病的中度抑郁障碍患者随机分为3组（各30例）:米氮平(30⁴5 mg·d^-1)组、舍曲林(125²00 mg·d^-1)组、心理治疗（每周进行1²次认知治疗）组,治疗时间均为12周。3组患者均于治疗前测定空腹血糖;另于治疗前及治疗第4、8、12周末分别测定血清总胆固醇及血清三酰甘油,比较测定值的变化。结果米氮平组、舍曲林组及心理治疗组分别脱落3例、1例及4例。在整个治疗期间,米氮平组与舍曲林组或心理治疗组比较,总胆固醇均有显著差异（P=0.030,P=0.016）,而后两组间无显著差异（P=1.000）;3组间相互比较,三酰甘油均无显著差异（均P>0.05）。12周末时,3组间血清总胆固醇升高率有显著差异（χ²=7.253,P=0.027）,且其总体频率的95%置信区间为0³.0%,米氮平组的升高率最高,且该组的升高率随治疗时点延长逐渐升高;米氮平组内第4、8、12周末分别与基线比较,三酰甘油均无显著差异（均P>0.05）。结论米氮平治疗伴2型糖尿病的中度抑郁障碍患者可导致总胆固醇水平升高,且其升高率随治疗时间的延长而逐渐增加;米氮平对该类患者的三酰甘油水平无明显影响。更多还原

【Abstract】 AIM To explore the effect of mirtazapine on lipid metabolism of depressive patients with type2 diabetes. METHODS Total 90 moderate depressive patients with type 2 diabetes were randomly divided into three groups: mirtazapine( 30-45 mg·d^-1) group, sertraline( 125-200 mg·d^-1) group, and psychotherapy（ weekly cognitive therapy for 1 to 2 times） group, n = 30 for each. Three groups would all have a 12-week treatment. The fasting blood glucose（FBG） of each group was measured at baseline. The total cholesterol（TC）and the triglyceride（ TG） of each group were measured at baseline and at wk 4, 8 and 12 of treatment for comparison. RESULTS The mirtazapine, sertraline and psychotherapy group had 3, 1 or 4 case being off,respectively. Throughout the treatment period, the TC of the mirtazapine group had statistical difference compared with the sertraline group and psychotherapy group respectively（P = 0.030, P = 0.016）, while there was no statistical difference between the sertraline group and psychotherapy group（P = 1.000）. Compared with each other among three groups, the TG level had no statistical difference（P > 0.05）. The increased rates of TC among three groups had statistical difference at wk 12（ χ²= 7.253, P = 0.027）, and the 95% confidence interval of the population rate was 0% to 3.0%. The increased rate of the mirtazapine group was the highest, and the rate increased gradually with the treatment points. The TG of the mirtazapine group had no statistical difference between at baseline and at wk 4, 8 or 12（ P > 0.05）. CONCLUSION Mirtazapine treatment of moderate depressive patients with type 2 diabetes can lead to elevated levels of serum TC, and the increased rate of TC rised gradually with the treatment time during the study period. Mirtazapine has no significant effect on serum TG levels in these patients.更多还原