帕罗西汀对维持性血液透析抑郁症并功能性消化不良患者的影响

Effect of Paroxetine on Maintenance Hemodialysis Patients with Depression and Functional Dyspepsia

目的:探讨帕罗西汀对维持性血液透析抑郁症并功能性消化不良患者的相关影响。方法:对45例维持性血液透析抑郁症并功能性消化不良患者应用帕罗西汀20 mg.d-1治疗8周,治疗期间观察药物不良反应;治疗前后应用汉密尔顿抑郁量表(HAMD)和改良主观全面营养评价法(MSGAN),对患者分别进行抑郁状态和营养不良的评估,以及功能性消化不良症状的评估,同时测定血清白蛋白(A lb)、血红蛋白(Hb)、铁蛋白(SF)、肌酐(SCr)、尿素氮(BUN)、钙(Ca)、磷(P)等生化指标。结果:治疗前后患者HAMD评分22.14±7.23和14.25±6.51,营养不良评分(MS)18.74±6.58和13.26±5.33,治疗后均明显降低,有极显著性差异(P<0.01),功能性消化不良的早饱和餐后饱胀不适症状改善,血清A lb、Hb、SF、BUN水平较治疗前提高(P<0.01,P<0.05),而SCr、Ca、P治疗前后无显著性差异(P>0.05)。患者不良反应发生率11.11%,均可耐受。结论:帕罗西汀能有效减轻维持性血液透析抑郁症并功能性消化不良患者的抑郁状态,同时改善患者的功能性消化不良症状和营养不良。

Objective： To investigate the effect of paroxetine on maintenance hemodialysis patients （MHD） with depression and functional dyspepsia. Methods： Forty- five MHD patients with depression and functional dyspepsia were selected to receive paroxetine 20mg/d for eight weeks. Side effects and functional dyspepsia were observed during treatment. Hamilton depression scale （HAMD） , the modified quantitative subjective global assessment of nutrition（MSGAN） and some biochemical parameters including serum albumin （Alb）, hemoglobin （Hb）, serum ferritin （SF）, serum creatinine （SCr）, urea nitrogen （ BUN）, calcium （Ca）, phosphorus（ P ） were measured to evaluate the depressive state and nutritional status before and after treatment. Results：HAMD scale 22.14 ± 7.23 vs 14.26 ± 6.51 ,malnutrition score （MS） 18.74 ± 6.58 vs 13.26 ± 5.33, were significantly decreased and the mean values of serum Alb, SF, Hb and BUN were significantly increased after treatment than before treatment （P 〈 0.01, P 〈 0.05 ） . whereas , there were no significant difference in serum Cr , Ca, P before and after treatment （P 〉 0. 05 ）. The functional dyspepsia symptoms were improved. Five patients （ 11.11% ） showed slight endurable side effects. Conclusion： Small dose paroxetine can alleviate the depressive state and improve the functional dyspepsia state as well as malnutrition in MHD patients with depression and functional dyspepsia.