西酞普兰在慢丙肝患者中IFN-α诱发精神症状中的作用分析

Function of citalopram in prevention of interferon-alpha associated depression in hepatitis C

目的探讨西酞普兰在干扰素治疗慢性丙型肝炎中诱发抑郁症的作用。方法将72例1b型慢性丙型肝炎患者根据Zung评分分为A、B、C三组,A组患者同时口服抗焦虑药物西酞普兰20mg/d,B、C组中的患者,没有给予抗焦虑治疗。所有3组患者均给予PEG-IFN-α联合利巴韦林抗病毒治疗,比较3组患者重度抑郁的发生率,同时对使用IFN后诱发重度抑郁的患者给予西酞普兰治疗,观察西酞普兰对干扰素诱发重度抑郁症的治疗效果。结果 1使用干扰素抗病毒治疗前加用西酞普兰,能显著降低干扰素引起抑郁症的发生率(A与B,A与C的P值分别为0.0062,0.0003)。使用干扰素之前,有轻度抑郁症的患者,在使用干扰素抗病毒之后,并不增加其重度抑郁的发生率(B、C的p值0.3612);2对于干扰素诱发的重度抑郁,使用西酞普兰安全有效,且不影响干扰素的抗病毒效率。结论西酞普兰临床应用于慢性丙型肝炎患者干扰素治疗过程中的精神症状安全有效。

Objective To oberserve the role of citalopram in prevention the IFN- α indeced depression in hepatitis C.Methods Totally 28 HCV infected patients with psychiatric disorders received a prophylactic medication with citalopram（ 20 mg / day） before and during therapy with peg- IFN- α. The incidence of major depression was compared with22 HCV infected patients with psychiatric disorders（ group B; n = 22） and without psychiatric risk factors（ group C; n= 22）,who underwent IFN- α treatment without a pre- emptive antidepressant therapy. The patient who were diagnosed major depressive during interferon- alpha treatment,were treated with citalopram（ 20 mg / day）. And then compare the Zung before and after the use of citalopram in the patient who were diagnosed major depressive. Results While the incidence of major depression in group B（ 50%） and the control patients（ group C）（ 62%） did not differ significantly,psychiatric patients with citalopram pre- treatment（ group A） developed significantly fewer depressive episodes（ 14%）during the treatment period. Patients who developed symptoms of major depression during IFN therapy could also be improved by antidepressive treatment. Conclusion IFN- α induced depression can be ameliorated and be prevented by citalopram.