米氮平与西酞普兰对老年抑郁症患者疗效及生活质量影响的对照研究

A comparative study on effect of mirtazapine and citalopram on quality of life in senile depressed patients

目的比较米氮平与西酞普兰治疗老年期抑郁症的疗效、不良反应及其对生活质量的影响。方法将符合入组标准的122例老年期抑郁症患者随机分为米氮平组62例，西酞普兰组60例。于治疗前和治疗后第2、4、6、8周末用汉密尔顿抑郁量表（HAMD）评定疾病严重程度和疗效；采用副反应量表（TESS）评定药物副反应，用生活质量综合评定问卷（GQOLI-74）于治疗前和治疗8周后评定生活质量。结果米氮平组有效率达67.7%，西酞普兰组有效率达70%；两组疗效差异不显著。但前者对食欲增加、睡眠和生活质量的改善显著优于后者（P〈0.05）。结论米氮平治疗老年抑郁症安全有效，改善睡眠好，不良反应少，能更好改善老年抑郁症患者的生活质量。

Objective To explore the efficacy of mirtazapine and citalopram and the effect on the quality of life in senile depressed patients. Methods 122 elderly patients with depression were randomly divided into mirtazapine group （n = 62） and citalopram group （n = 60）. Pretreatment and 2, 4, 6 and 8 weeks post- treatment, the efficacy and side effects were evaluated by Hamilton depressive scale （HAMD） and treatment emergent symptom scale （TESS）. The quality of life was assessed with Generic Quality of Life Inventory-74 （GQOLI-74）. Results The effective rates of mirtazapine and citalopram were 67.7% and 70.0% respectively, which was no significant difference between two groups. After eight weeks of treatment, the scores of HAMD were significantly lower in both groups compared to pre- treatment. Mirtazapine, however, displayed significant effects on increasing food appetite, improving sleep disorder and quality of life compared to citalopram （P ~ 0.05）. Conclusions Mirtazapine is an ef- fective and safe drug in the treatment of elderly patients with depression and able to improve the quality of life in these patients.