文拉法辛与阿米替林对产后抑郁症患者细胞因子的影响及其疗效比较

Effect of Venlafaxine or Amitriptyline on Cytokines in Postpartum Depression Women and Its Clinical Efficacy

【目的】比较文拉法辛与阿米替林对产后抑郁症患者细胞因子的影响及临床疗效。[方法]58例产后抑郁症患者，按不同治疗方法分为两组。文拉法辛纽（A组，n=30），文拉法辛25-275mg／d，分1-3次口服。阿米替林组（B组，n=28），阿米替林50-250mg／d，分1-3次口服，两组疗程均为8周。分别在治疗前和治疗后清晨空腹取静脉血5mL，ELISA法检测IL-6、IL-1β、TNF-α水平，并选取30例正常产后妇女为正常对照（C组）。采用汉密顿抑郁量表（HAMD）及副反应量表（TESS）分别于治疗前及治疗2、4、6、8周末各评定1次疗效及不良反应。【结果】A、B两组患者IL-6、TNp-α水平在治疗前均高于正常组（P〈0．05）。两组治疗后IL-6、TNF-α水平较治疗前明显下降（P〈0．05），HAMD评分亦显著下降（P〈0．05），但组间比较差异无统计学意义（P〉0．05）。A、B两组患者的有效率分别为73．3％、67．8％，差异无统计学意义（P〉0．05）。两组治疗后2、4、8周末TESS总分评定A明显均低于B组（P〈0．05）。【结论】文拉法辛与阿米替林治疗产后抑郁症疗效相当，均可降低患者IL-6、TNF-α水平，文拉法辛的不良反应更小，患者的耐受性较好。

[Objective]To compare the effects of venlafaxine and amitriptyline on cytokines in postpartum depression women and their clinical efficacy. [Methods] Fifty-eight women suffered with postpartum depression were randomized into 2 groups. In Group A, all women（n=30） were treated with venlafaxine with first dose of 25mg/d and then was gradually treated with more high dose,and the maximum dose was 275 mg/d. In Group B, all women （n=28） were treated with amitriptyline with first dose of 50mg/d, and then was gradually treated with more high dose,and the maximum dose was 250 mg/d. The levels of IL-6, IL-1β and TNF-a were measured before treatment and at the end of treatment after 8 weeks. HAMD and TESS scores were re- corded before treatment, after 2 week treatment, after 4-week treatment and g-week-treatment. And the total effective rate was recorded after 8 weeks. [Results] The levels of IL-6 and TNF-ain postpartum depression women were higher than those of normal women. （ P 〈0.05）. The levels of IL-6 and TNF-awere significantly decreased after 8-week treatment（ P 〈0.05）. HAMD was gradually improved after 2, 4 and 8 weeks（ P〈0. 05）. And there was no significant difference in HAMD score between A and B. The effective rate of group A and group B were 73. 3% and 67. 8% （ P 〈0. 05）. TESS scores in group A were significantly lower than those in group B after 2,4 and 8 weeks（ P 〈0.05）. [Conclusion]Both venlafaxine and amitriptyline can improve postpartum depression state and decreased IL-6 and TNF-alevels. Venlafaxine has fewer side effects than amitriptyline, and has good tolerance.