【摘要】 目的:探讨盐酸美金刚对重性抑郁症患者血清中脑源性神经营养因子(BDNF)及临床疗效的影响。方法:利用随机数字表法将105例重性抑郁症患者随机分为研究组(n=52)与对照组(n=53)。两组给予舍曲林治疗,在此基础上研究组加用20 mg/d盐酸美金刚,对照组加用安慰剂,治疗6周。比较两组治疗2、4、6周时BDNF水平、汉密尔顿抑郁量表(HAMD)评分及汉密尔顿焦虑量表(HAMA)评分。采用治疗中出现的症状量表(TESS)评估不良反应。结果:两组HAMD、HAMA评分均随着治疗时间增长而减少,研究组HAMD、HAMA评分下降幅度与对照组比较差别有统计学意义(P<0.05)。治疗后,两组BDNF水平均随着治疗时间增长而增高,研究组增高幅度与对照组比较差别有统计学意义(P<0.05)。研究组血清BDNF增加率与HAMD减分率呈正相关(r=0.296,P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:盐酸美金刚联合舍曲林在治疗6周内较单用舍曲林能更迅速、更有效降低重性抑郁症患者的临床症状,其原因可能是升高了患者体内的BDNF水平。更多还原

【Abstract】 Objective: To explore the influences of memantine in treatment of patients with major depressive disorder on serum brain-derived neurotrophic factor(BDNF) and clinical effect. Method:A total of 105 patients with major depressive disorder were divided into research group(n=52) and control group(n=53) according to random number table.All patients were orally given sertraline.The two groups were additionally given memantine(20 mg/d,the research group) or placebo(the control group) for 6 weeks.The patients were evaluated with BDNF,the Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA) at baseline and two,four and six weeks after treatment respectively.The adverse events were monitored by Treatment Emergent Symptoms Scale(TESS). Results:There were significant reductions in the HAMA and HAMD scores in the two groups at each time point.The HAMA and HAMD scores in the research group were significantly lower than those in the control group(P<0.05).After treatment, the serum levels of BDNF in the research group were significantly higher than those in the control group(P<0.05).There was a positive correlation between serum BDNF increase rate and HAMD reduction rate in the research group(r=0.296,P<0.05).There were no statistically significant differences in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Memantine combined with sertraline is safer and more effective to alleviate the clinical symptoms of patients with major depressive disorder than sertraline monotherapy in 6 weeks,which might be attributed to the increase of the serum BDNF.更多还原