度洛西汀对男性首发抑郁症患者性激素、骨密度、睡眠质量及神经功能的影响

Effect of duloxetine on sex hormone,bone mineral density,sleep quality and neurological function in male patients with first-episode depression

目的:分析度洛西汀对男性首发抑郁症患者性激素、骨密度、睡眠质量及神经功能的影响。方法:选取2012年4月至2015年4月本院收治的42例男性首发抑郁症患者作为研究对象,均采取度洛西汀治疗,比较患者治疗前后性激素水平、骨密度、睡眠质量及神经功能的变化情况,评估度洛西汀在抑郁症中的应用价值,并与男健康者对照。结果:治疗后患者雌二醇、睾酮水平分别为(351.05±175.56)pmol·L-1、(64.63±17.41)nmol·L-1,与治疗前相比差异均有统计学意义(P<0.05),但仍低于健康对照(P<0.05);患者胫骨骨密度、腰椎L1-L4骨密度分别降低至(0.73±0.08)、(0.91±0.11)g·cm-2,与治疗前及健康对照相相比差异均无统计学意义(P>0.05);患者入睡时间、睡眠时间、睡眠效率、日间功能、睡眠质量、睡眠障碍评分分别为(1.57±0.81)、(1.21±0.66)、(1.21±0.78)、(1.30±0.49)、(1.43±0.88)、(1.12±0.74)分,与治疗前相比差异均有统计学意义(P<0.05);患者仅韦克斯勒成人智力测量表测试评分上升至(12.07±8.33)分,与治疗前相比差异有统计学意义(P<0.05);本组痊愈18例(42.86%),有效20例(47.62%),无效4例(9.52%),总有效率为90.48%。结论:度洛西汀治疗可改善男性首发抑郁症患者性激素水平,优化睡眠质量与神经功能,对患者骨密度无不良影响,值得推广。

Objective To analyze the effect of duloxetine on sex hormone, bone mineral density, sleep quality and neurological function in the male patients with primary depressive disorder. Methods 42 cases of male patients with primary depressive disorder who were admitted in our hospital between April 2012 and April 2015 were selected as the study objects and were included in the observation group. All the patients were treated with duloxetine. The changes of sex hormone level, bone mineral density, sleep quality and neurological function before and after the treatment were compared. The application value of duloxetine in depressive disorder was evaluated and compared with that in normal healthy people. Results After the treatment, ①The levels of estradiol and testosterone were （351.05±175.56） pmol·L^-1 and （64.63±17.41） nmol/L, respectively. Compared with those before the treatment, there were significant differences （P〈0.05） but they were lower than those in normal healthy people （P〈0.05）; ②the tibia bone mineral density and L1-L4 bone mineral density of the patients decreased to（0.73±0.08）g·cm^-2 and（0.91±0.11）g·cm^-2 , respectively. Compared with those before the treatment, there were no significant differences （P〉0.05） and compared with those in in normal healthy people, there also were no significant differences （P〉0.05） ;③the scores of time to falling asleep, sleep time, sleep efficiency, daytime function, sleep quality and sleep disturbance were （1.57± 0.81）, （1.21±0.66）, （1.12±0.78）, （1.30±0.49）,（1.43±0.88）and（1.12±0.74）, respectively. Compared with those before the treatment, the differences were statistically significant （P〈0.05）; ④only the test scores of Wechsler adult intelligence measurement table increased to （12.07±8.33）. Compared with that before the treatment, the difference was statistically significant （P 〈 0.05）; ⑤In this group, 18 cases were cured （42.86%）, 20 cases were effective （47.62%） and 4 cases were invalid （9.52%）. The total