艾司西酞普兰联合米氮平对老年抑郁症患者认知功能及血清NSE、MHPG水平的影响

Effects of escitalopram combined with mirtazapine on cognitive function and serum NSE and MHPC levels in elderly patients with depression

目的 研究艾司西酞普兰联合米氮平对老年抑郁症患者认知功能及血清神经元特异性烯醇化酶(NSE)、3-甲基-4羟苯乙二醇(MHPG)水平的影响。方法 以2021年1月至2023年1月该院收治的102例老年抑郁症患者为研究对象,采用随机数字表法分为联合组、对照组,每组51例。对照组给予艾司西酞普兰治疗,联合组给予艾司西酞普兰联合米氮平治疗。比较两组临床疗效,治疗前及治疗4周后汉密尔顿抑郁量表(HAMD)、蒙特利尔认知评估量表中文版(MoCA)、匹兹堡睡眠质量指数(PSQI)评分,P300事件相关电位(波幅、潜伏期),血清神经递质[NSE、MHPG、高香草酸(HVA)]水平,以及不良反应发生率。结果 联合组临床总有效率为92.16%,高于对照组的76.47%(P<0.05);治疗4周后,联合组HAMD、PSQI评分低于对照组,MoCA评分高于对照组,差异有统计学意义(P<0.05);治疗4周后,联合组P300潜伏期短于对照组,P300波幅高于对照组,差异有统计学意义(P<0.05);治疗4周后,联合组血清NSE水平低于对照组,MHPG、HVA水平高于对照组,差异有统计学意义(P<0.05);联合组不良反应总发生率(11.76%)与对照组(7.84%)比较,差异无统计学意义(P>0.05)。结论 采用艾司西酞普兰与米氮平联合治疗可有效增强老年抑郁症患者认知功能,缓解抑郁症状、睡眠障碍,提高疗效,且有一定安全性。

Objective To investigate the effects of escitalopram combined with mirtazapine on the cognitive function and serum neuron-specific enolase(NSE)and 3-methyl-4-hydroxyphenylate glycol(MHPG)levels in elderly patients with depression.Methods A total of 102 elderly patients with depression admitted and treated in this hospital from January 2021 to January 2023 served as the research subjects and divided into the combination group and control group by the random number table method,51 cases in each group.The control group was treated with escitalopram,and the combination group was treated with escitalopram combined with mirtazapine.The clinical efficacy,Hamilton Depression Scale(HAMD)score,the Chinese version of the Montreal Cognitive Assessment Scale(MoCA)score,Pittsburgh Sleep Quality Index(PSQI)score,P300 event-related potential(amplitude,latency),serum neurotransmitters[NSE,MHPG and homovanillic acid(HVA)]levels before and in 4 weeks after treatment and incidence rates of adverse reactions were compared between the two groups.Results The total effective rate in the combination group was 92.16%,which was higher than 76.47%in the control group(P<0.05).After the 4-week treatment,the HAMD and PSQI scores in the combination group were lower than those in the control group,the MoCA score was higher than that in control group,and the differences were statistically significant(P<0.05).After the 4-week treatment,the P300 latency in the combination group was shorter than that in the control group,the P300 amplitude was higher than that in the control group,and the differences were statistically significant(P<0.05).After the 4-week treatment,the serum NSE level in the combination group was lower than that in the control group,while the MHPG and HVA levels were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence rates of adverse reactions between the combined group and control group(11.76%vs.7.84%,P>0.05).Conclusion The treatment of escitalopram combined with mirtazapine in elderly patients with depression could effectively enhance the cognitive function,relieve the depressive symptoms and sleep disorders,and increase the treatment effect,moreover which has certain safety.