艾司西酞普兰治疗抑郁症患者的早期疗效及其与血药浓度的关系

Early efficacy and its correlation with plasma concentration of escitalopram in patients with depression

目的:探讨艾司西酞普兰治疗抑郁症患者的早期疗效及其与血药浓度的关系。方法:对47例抑郁症患者应用艾司西酞普兰系统治疗,于治疗前及第1、2周进行汉密顿抑郁量表17项(HAND)评估,同时采用高效液相色谱-质谱法(HPLC-MS)测定血药浓度。结果:治疗1周有效率23.4%,无患者治愈;血药浓度在有效者[13.43±4.78)ng/ml]与无效者[(11.28±10.30)ng/ml]间差异无统计学意义。治疗2周治疗有效率59.6%,治愈率为25.5%;血药浓度有效者[(18.97±13.77)ng/ml]与治愈者[(19.65±11.42)ng/ml]差异无统计学意义,但均显著高于无效者[(6.52±3.36)ng/ml](P均<0.01)。有效者治疗1、2周时焦虑/躯体化因子分较无效者显著改善(P<0.05或P<0.01)。结论:艾司西酞普兰治疗抑郁发作(含伴焦虑)早期疗效良好;监测其血药浓度具有临床意义。

To explore the early efficacy and its correlation with plasma concentration of es-citalopram in patients with depression. Method：Forty-seven depressive patients receoived escitalopram sys-tem treatment. They were assessed by Hamilton rating scale for depression-17 items（HAMD）before treatment, one and two weeks after treatment. Meanwhile,their plasma concentration of escitalopram was detected by high performance liquid chromatography-mass spectrometry（HPLC-MS）. Results：At the end of the first week,the effective rate was 23. 4± and no one was of cure. The plasma concentrations between the effective patient [（13. 43 ± 4. 78）ng/ ml]and invalid patients[（11. 28 ± 10. 30）ng/ ml]was no significantly difference. At the end of the second week,the effective rate was 59. 6± and cure rate was 25. 5± . The plasma concentrations be-tween the effective patient[（18. 97 ± 13. 77）ng/ ml]and the recovered patients[（19. 65 ± 11. 42）ng/ ml]was no significantly different;but all of those were significantly higher than invalid patients[（6. 52 ± 3. 36）ng/ml]（all P ﹤ 0. 01）. The scores of anxiety/ somatization factors of HAMD in effective patien at end of the first and second week were significantly improved than those in invalid patients（P ﹤ 0. 05 or P ﹤ 0. 01）. Conclu-sion：The early efficacy of escitalopram in depressive patients（including combined anxiety）is good. Monitor the blood drug concentration has clinical significance.