氟西汀联合奥氮平对帕金森病伴抑郁的疗效及P300的影响

Impact on P300 of fluoxetine combined with olanzapine for Parkinson's disease patients with depression

目的探讨氟西汀联合奥氮平治疗对帕金森病（PD）伴抑郁患者的疗效及P300影响。方法收集2011年6月~2013年6月在我院神经内科就诊的PD伴抑郁患者136例,根据随机数字表法分为联合组和氟西汀组,各68例。氟西汀组应用氟西汀治疗。联合组应用氟西汀联合奥氮平治疗。比较两组的临床疗效和治疗前后P300中N2、P3波潜伏期和P3波幅变化情况。结果联合组有效率明显高于氟西汀组（P〈0.05）。两组治疗前HAMD评分无明显差异,治疗后均明显低于治疗前（P〈0.05）,但联合组降低程度明显大于氟西汀组（P〈0.05）。两组治疗后N2、P3潜伏期均比治疗前缩短,P3波幅较治疗前升高（P〈0.05）,但联合组N2、P3潜伏期缩短程度大于氟西汀组（P〈0.05）,P3波幅升高幅度大于氟西汀组（P〈0.05）。结论与单纯氟西汀相比,氟西汀联合奥氮平治疗PD伴抑郁患者具有协同增效的作用,能更有效缩短PD伴抑郁患者P300中的N2、P3潜伏期,抬高P3波幅,从而提高临床疗效。

Objective To investigate Impact on P300 of fluoxetine combined with olanzapine in Parkinson’s disease patients with depression. Methods 136 PD patients with depression in internal medicine department in our hospital from Jun,2011 to Jun,2013 were collected. According to random digits table method,they were divided into combination group and fluoxetine group,there were 68 patients in each group. Fluoxetine group was treated with fluoxetine,combination group was treated by fluoxetine combined with olanzapine. The clinical curative effect,the N2 or P3 wave latency and P3 wave amplitude changes in P300 before and after treatment were compared between two groups. Results The efficiency rate in combination group was obviously higher than that in fluoxetine group（P〈0.05）. The HAMD score before treatment in two groups had no significant difference,after treatment that was significantly lower than that before treatment（P〈0.05）,but that in combination group decreased significantly than that in fluoxetine group（P〈0.05）. The N2 or P3 latency after treatment in two groups were shorter than that before treatment, the P3 amplitude increased than that before treatment（P〈0.05）, but the N2 or P3 latency in combination group were greater than those in fluoxetine group（P〈0.05）,the P3 amplitude was higher than that in fluoxetine group（P〈0.05）. Conclusion Compared with simple fluoxetine in by fluoxetine combined with olanzapine treating PD patients with depression has synergistic effects, it can more effectively shorten N2 or P3 latency and raise P3 amplitude in P300 of PD patient with depression,so as to improve clinical efficacy.