选择性5-HT再摄取抑制剂联合大剂量阿司匹林对重度抑郁症患者短期自杀风险影响的初步研究

The effect of SSRI combined with high dose of aspirin on suicidal ideation in major depressive disorder

目的评价选择性5-HT再摄取抑制剂(SSRI)联合大剂量阿司匹林对重度抑郁症患者短期自杀风险的影响。方法将C-反应蛋白(CRP)水平≥1 mg/L的重度抑郁症患者随机分为两组,治疗组接受标准SSRI治疗加阿司匹林300 mg每日一次口服治疗,对照组接受标准SSRI治疗加安慰剂治疗。治疗21 d后,停用阿司匹林和安慰剂。治疗前及治疗后第3天、第1周、第4周和第8周采用Beck自杀意念量表、汉密顿抑郁量表和蒙哥马利抑郁评定量表进行评分。结果治疗组和对照组分别有16例和18例患者参与疗效分析,两组基线匹配。治疗3 d和治疗1周后,治疗组CRP水平相比对照组显著下降,同时Beck自杀意念量表评分和汉密顿抑郁量表评分也显著下降;治疗第4周后,两组CRP水平无显著差异,但治疗组相比对照组Beck自杀意念量表评分和汉密顿抑郁量表评分仍显著下降,两组第8周各项评分差异无统计学意义。结论 SSRI联合大剂量阿司匹林治疗能显著降低重度抑郁症患者患者内的自杀风险。

Objective To study whether SSRI （selective serotonin reuptake inhibitor） combined with high dose of Aspirin might improve suicidal ideation in major depressive disorder. Methods Patients with major depression disorder and CRP ≥ 1 mg/L were randomly divided into two groups. Treatment group were treated with standard SSRI combined with Aspirin 300 mg/d. Control group were treated with standard SSRI and placebo. After 21 days treatment, Aspirin and placebo were discontinued. Beck Scale for Suicide Ideation （BSS）, Hamilton Depression Scale （HAMD） and Montgomery Depression Rating Scale （MADRS） were measured before and 3 days, 1 week, 4 weeks and 8 weeks after treatment. Results 16 and 18 subjects completed the therapy in treatment group and control group, respectively. After 3 days and 1 week treatment, CRP level, BSS score and MD score were significantly decreased in treatment group compared to control group; After 4 weeks treatment, there were no significant difference in CRP level between the two groups, but BSS score and HAMD score were still significantly decreased in treatment group. All three scores were no significant difference between both groups after 8 weeks treatment. Conclusion SSRI combined with a high dose of Aspirin might improve suicidal ideation in patients with major depressive disorder.