帕罗西汀治疗维持性血液透析患者合并抑郁症的疗效

Effect of paroxetine for treating complicating depression in maintenance hemodialysis patients

目的探讨帕罗西汀辅助治疗维持性血液透析患者合并抑郁症的有效性。方法将60例诊断为维持性血液透析合并抑郁症的患者分为对照组和观察组,每组30例。对照组给予常规治疗方案(血液透析、并发症治疗、纠正肾性贫血等),观察组在常规治疗基础上,给予服用帕罗西汀10mg,每日1次,连续治疗8周。统计两组患者的临床症状、血红蛋白(Hb)、血清清蛋白(ALB)、Kt/V、铁蛋白(SF)、全段甲状旁腺激素(iPTH)、汉密尔顿抑郁量表(HAMD)评分及疗效。结果治疗8周以后,观察组和对照组患者的临床症状、Hb、ALB、Kt/V均较治疗前有明显改善(P<0.05);iPTH、SF、HAMD评分较治疗前降低(P<0.05)。观察组有效率86.67%,对照组有效率为23.33%,两组比较差异有统计学意义(P<0.05)。结论使用帕罗西汀辅助治疗维持性血液透析伴发抑郁症状,能提高维持性血液透析患者生存质量。

Objective To investigate the effect of paroxetine in the adjuvant treatment of maintenance hemodialysis（MHD）com-plicating depression.Methods 60 patients with MHD complicating depression were randomly divided into the control group and the observation group,30 cases in each group.The control group received the routine therapeutical scheme（hemodialysis,complication treatment and correcting the renal anemia,etc）.On the basis of the routine therapy the observation group was given oral paroxetine 10 mg/d,once daily for continuous 8 weeks.The depression level was assessed by the Hamilton depression scale（HAMD）.The clinical symptoms,levels of Hb,ALB,Kt/V,iPTH,SF and HAMD scores were statistically analyzed and compared between the two groups.Results The clinical symptoms,levels of Hb,ALB,Kt/V after 8-week treatment in the two groups were significantly im-proved compared with pretherapy（P〈0.05）;the level of iPTH,SF and the HAMD scores in the two groups were decreased com-pared with pretherapy（P〈0.05）.The effective rate of depression was 86.67% in the observation group and 23.33% in the control group,the difference between the two groups had statistical significance（P〈0.05）.Conclusion Paroxetine in the assisted treat-ment of MHD complicating depression symptom can improve the quality of life in MHD patients.