西酞普兰联合丙戊酸盐治疗双相情感障碍躁狂发作的疗效

Efficacy of Citalopram Combined with Valproate on Bipolar Affective Disorder Manic Episode

目的探讨西酞普兰联合丙戊酸盐对双相情感障碍躁狂发作的疗效及对血清巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、白细胞介素-1β(interleukin-1β,IL-1β)及白细胞介素-6(interleukin-6,IL-6)水平的影响。方法选取2016年1月至2018年5月我院收治的153例双相情感障碍躁狂发作患者,随机分为对照组(76例)和研究组(77例)。对照组给予丙戊酸钠治疗,研究组给予西酞普兰联合丙戊酸钠治疗,两组均治疗8周。评价并比较两组治疗前后的倍克-拉范森躁狂量表(bech-Rafaelsen manic rating scale,BRMS)评分和生活质量综合评定问卷(general quality of life inventory,GQL-LI)评分。比较两组治疗前后MIF、IL-1β及IL-6水平和两组治疗过程中不良反应的发生情况。结果两组治疗后BRMS评分低于治疗前(P<0.05),GQL-LI评分高于治疗前(P<0.05);治疗后研究组改善程度均优于对照组(P均<0.05)。两组患者治疗后血清MIF、IL-1β及IL-6水平均较治疗前下降(P均<0.05),治疗后研究组MIF、IL-1β及IL-6水平均比对照组低(P均<0.05)。研究组不良反应发生率与对照组比较差异无统计学意义(χ^2=0.840,P=0.359)。结论西酞普兰联合丙戊酸盐治疗双相情感障碍躁狂发作,能够减轻患者的临床症状,提高生活质量,其作用机制可能与抑制血清炎症因子表达有关。

Objective To investigate the efficacy of citalopram combined with valproate on bipolar affective disorder manic episode and its effect on the serum macrophage migration inhibitory factor(MIF),interleukin-1β(IL-1β)and interleukin-6(IL-6)level.Methods A total of 153 patients with bipolar affective disorder manic episode admitted in our hospital from January 2016 to May 2018 were selected. They were randomly divided into control group(76 cases) and research group(77 cases).The control group was treated with valproate,while the research group was treated with citalopram combined with valproate. The two groups were treated for 8 weeks.The score of Bech-Rafaelsen manic rating scale(BRMS) and General Quality of Life Inventory(GQL-LI)before and after treatment was evaluated and compared between the two groups. The level of MIF,IL-1β and IL-6 was measured and compared before and after treatment in the two groups. The incidence of adverse reactions during the treatment was compared between the two groups. Results After treatment,BRMS score in the two groups were significantly lower than those before treatment(P<0.05).GQL-LI score was significantly higher than those before treatment(P<0.05).After treatment,the improvement of the research group was significantly better than the control group(P all<0.05).The level of serum MIF,IL-1β and IL-6 in the two groups was significantly lower than those before treatment(P all <0.05),and the levels of MIF,IL-1β and IL-6 in the research group were lower than those in the control group(P all <0.05).There was no significant difference in the incidence of adverse reactions between the research group and the control group (χ^2=0.840,P=0.359). Conclusion Citalopram combined with valproate in treatment of bipolar affective disorder manic episode can reduce the clinical symptoms,improve the quality of life,and its mechanism may be related to inhibiting the expression of serum inflammatory factors.