米氮平和舍曲林对抑郁症血糖影响的对照研究

The effects of mirtazapine and sertraline on blood glucose in patients with depressive disorder

目的探讨米氮平对抑郁障碍患者空腹血糖（FBG）的影响。方法将93例抑郁障碍患者采用随机数字表法随机分为米氮平组、米氮平联合舍曲林组（以下简称联合用药组）、舍曲林组，每组31例；治疗观察期均为12周；3组患者于治疗前及治疗后第4、8、12周末测定FBG进行比较。结果米氮平组与联合用药组间FBG的差异无统计学意义（P〉0．05），而此上述2组FBG均高于舍曲林组，差异有统计学意义（P均〈0．05）；米氮平组和联合用药组基线与第4周末FBG比较，差异无统计学意义（P均〉0．05），而基线与第8周末或第12周末比较，差异有统计学意义（P均〈0．05）；舍曲林组基线与第4、8、12周末FBG比较，差异无统计学意义（P均〉0．05）；3组间在第4周末或第8周末出现空腹血糖过高（IFG）频率的差异无统计学意义（P均〉0．05），而在第12周末，米氮平组或联合用药组与舍曲林组间出现IFG频率的差异有统计学意义（P均〈0．05）。结论米氮平单一或联合舍曲林治疗既往无糖代谢异常的抑郁障碍患者可出现有临床意义的IFG，且IFG出现的频率可能有随时间延长而增加的趋势。

Objective To explore the effects of mirtazapine on fasting blood glucose （FBG） in depressive patients. Methods Ninety-three patients were randomly divided into three groups with 31 in each, who were treated with mirtazapine, mirtazapine plus sertraline（ combined）, or sertraline for 12 weeks. The FBG were measured at baseline and at weeks 4, 8 and 12. Results The mean FBG was not significantly different between the mirtazapine group and the combined group （ P 〉 0. 05 ）, which were higher than the sertraline group（ P 〈 0.05 ）. The mean FBG of the mirtazapine or the combined group was not significantly different at baseline and at weeks 4（P 〉0.05）, but differences between baseline and at weeks 8 or 12（P 〈 0. 05 ） were significant. The mean FBG of the sertraline group was not statistically different between baseline and at weeks 4 or 8 or 12（P 〉0.05）. The rates of impaired fasting glucose （IFG） among three groups were not statistically different at weeks 4 or 8 （ P 〉 0.05）, but was significantly different between the mirtazapine or the combined group and the sertraline group at weeks 12 （ P 〈 0.05 ）. Conclusions The results indicate the treatment of mirtazapine could have influence on glucose metabolism.