伴不同程度焦虑症状的抑郁症患者文拉法辛的疗效比较

Curative effect comparison of venlafaxine between depression patients with different degrees of anxiety

目的:比较伴不同程度焦虑症状的抑郁症患者文拉法辛的疗效。方法:224例抑郁症患者根据汉密尔顿焦虑量表(HAMA)评分分为明显焦虑组(HAMA≥14分,158例)及可能焦虑组(HAMA<14分,66例),均给予文拉法辛单药治疗52周。治疗前进行汉密尔顿抑郁量表-17(HAMD-17)、HAMA和自杀意念自评量表(SIOSS)测评;以治疗后HAMD减分率≥50%为有效;治疗后第2周末HAMD减分率≥25%为早期起效;比较两组治疗后第2、4、8、12、52周时的疗效。结果:明显焦虑组146例(91.78%)、可能焦虑组61例(91.80%)完成随访;明显焦虑组的自杀风险率(60.1%)显著高于可能焦虑组(25.8%)(P<0.01);治疗前后各时间点HAMD评分显著高于可能焦虑组(P<0.05或P<0.01);治疗后早期起效率(治疗后2周)、持续有效率(治疗后4周)、临床痊愈率(治疗后8周)、持续临床痊愈率(治疗后12周)显著低于可能焦虑组(P均<0.05);复发率(29.1%)显著高于可能焦虑组(15.2%)(P<0.05)。结论:文拉法辛对无或伴轻度焦虑症状的抑郁症患者疗效明显好于伴有明显焦虑症状的患者。

Objective:To compare the curative effect of venlafaxine between depression patients with different degrees of anxiety.Method:According to their scores of Hamilton anxiety scale(HAMA),224 depression patients were divided into obvious anxiety group(HAMA≥14,158 cases)and possible anxiety group(HAMA<14,66 cases).Both groups had been given monotherapy of venlafaxine for 52 weeks.All patients had been evaluated by Hamilton depression scale(HAMD-17),HAMA and self-rating idea of suicide scale(SIOSS)before treatment.After treatment,the decrease rate of HAMD score≥50%was regarded as effective.After two weeks of treatment,the decrease rate of HAMD score≥25%was regarded as early response.The curative effect of the two groups were compared at 2,4,8,12 and 52 weeks after treatment.Results:146 cases(91.78%)of the obvious anxiety group and 61 cases(91.80%)of the possible anxiety group had been followed up.In the obvious anxiety group,the suicide risk rate(60.1%)was significantly higher than that of the possible anxiety group(25.8%)(P<0.01);the HAMD scores of each time point were significantly higher than those in the possible anxiety group(P<0.05 or P<0.01);the early response(2 weeks after treatment),continuous efficiency(4 weeks after treatment),clinical recovery(8 weeks after treatment),and continuous clinical recovery(12 weeks after treatment)were significantly lower than those in the possible anxiety group(all P<0.05);the recurrence rate(29.1%)was significantly higher than that of the possible anxiety group(15.2%)(P<0.05).Conclusion:The effect of venlafaxine on depression patients with mild or no anxiety is much better than that on depression patients with obvious anxiety.