米氮平对抑郁症患者认知功能的影响

Effect of mirtazapine on cognitive function in patients with depression

目的探讨米氮平对抑郁症认知功能的影响。方法选择35例抑郁症患者为研究组予米氮平治疗,治疗8周;选择35名健康人作为对照组。两组入组时及研究组治疗后采用韦氏数字广度(DS)、威斯康星分类卡片(WCST)及爱荷华赌博任务(IGT)测试;以汉密顿抑郁量表(HAMD)的减分率评定米氮平疗效。结果研究组有效率77%,痊愈率为43%;入组时研究组WCST总应答数、持续错误应答数和非持续错误应答数均高于对照组,完成分类数低于对照组(P<0.05);研究组治疗后WCST持续错误应答数较入组时减少,完成分类数较入组时提高(P<0.05);入组时研究组IGT的第1、4模块评分高于对照组(P<0.05)。结论米氮平能够改善抑郁症患者短时记忆力以及执行功能损害,但对情感决策损害改善不明显。

Objective To investigate the effect of mirtazapine on cognitive function in patients with depression. Methods 35 patients with depression （study group） were treated with mirtazapine for 8 weeks. 35 healthy controls were recruited as control group. All cases in study group were assessed with Hamilton Depression Scale （HAMD）, Wecbsler Digit Span （DS）, Wisconsin Card Sorting Test （WCST） and Iowa Gambling Task （IGT） at baseline and at the end of the 8-week treatment. The efficacy of mirtazapine was evaluated by using reduction rate of HAMD. Cases in control group were assessed with DS, WCST and IGT. Results The response rate was 77% and the recovery rate was 43% in study group. Numbers of total correct responses, perseverative errors and non-perseverative errors of WCST at baseline were significantly higher in study group than those in control group, and number of categories completed at baseline in study group was significantly lower than that in control group （ P 〈 0.05 ）. Compared with the baseline, number of perseverative errors of WCST in study group decreased significantly and number of categories completed in study group increased significantly at the end of the treatment （ P 〈 0.05 ）. Scores of 1 st and 4＇h module of IGT at baseline in study group was significantly higher than those in control group （ P 〈 0.05 ）. Conclusion Mirtazapine can improve the lesions of short-term memory and executive function in depressive patients, but it takes little effect on dysfunction of affective decision-making.