艾司西酞普兰与氟西汀治疗老年抑郁症疗效及安全性对照研究

Efficacy and Safety of Escitalopram versus Fluoxetin for Geriatric Depression:A Meta-Analysis.

目的比较艾司西酞普兰与氟西汀治疗老年抑郁症的疗效及安全性。方法对艾司西酞普兰与氟西汀治疗老年抑郁症对照研究进行系统评价,应用循证医学的研究方法,使用专用的统计分析软件Revman5.1进行Meta分析。结果 11篇随机对照研究满足纳入标准。Meta分析的结果显示,疗程结束后两组之间有效率比较,其OR值为1.61(95%CI:1.08,2.40),氟西汀组有效率高于艾司西酞普兰组(Z=2.32,P=0.02);疗程结束后两组之间痊愈率比较,其OR值为1.15(95%CI:0.87～1.51),两组之间痊愈率相当(Z=0.97,P=0.33);疗程结束后两组之间不良反应比较,其OR值为0.66(95%CI:047～0.93),艾司西酞普兰组不良反应少于氟西汀组(Z=2.35,P=0.02)。结论艾司西酞普兰是一种有效治疗老年抑郁症的抗抑郁药物,且较氟西汀更安全,但疗效略差于氟西汀。

Objective To systematically evaluate the efficacy and safety of escitalopram versus fluoxetin for geriatric depression.Methods The randomized controlled trials（RCT）comparing the efficacy of escitalopram and fluoxetine in the treatment of geriatric depression wae systematically evaluated.Evidence-based medicine research methods were applied and statistical analysis software Revman 5.1 was used to Meta-analysis.Results 11 studies met inclusion criteria.Analyzed in effective rate,OR was 1.61,the confidence interval of 95% was（1.08,2.40）,fluoxetine group had better efficacy than escitalopram group after the last course of treatment（Z=2.32,P=0.02）;Analyzed in final cure rate,OR was 1.15,the confidence interval of 95%was（0.87,1.51）,there was no significant difference between escitalopram group and fluoxetine group after the last course of treatment（Z=0.97,P=0.33）;Analyzed in adverse reactions rate,OR was 0.66,the confidence interval of 95%was（047,0.93）,escitalopram group had fewer side effect than fluoxetine group after the last course of treatment（Z=2.35,P=0.02）.Conclusion Escitalopram is an effective and safe antidepressant.Fluoxetine in the treatment of geriatric depression has better efficacy than escitalopram.