阿戈美拉汀对双相抑郁发作伴睡眠节律紊乱患者睡眠质量及抑郁情绪的影响

Effect of Agomelatine on sleep quality and depressive mood in patients with bipolar depression accompanied by disturbed sleep rhythm

目的探讨双相抑郁发作伴睡眠节律紊乱患者采用阿戈美拉汀治疗对睡眠质量、抑郁情绪及雌激素水平的影响。方法选取2021年10月至2023年1月抚州市第三医院心身医学科收治的54例双相情感障碍患者为研究对象,所有患者处于轻中度抑郁状态伴睡眠节律紊乱,按照随机数字表法将其分为对照组和观察组,各27例。对照组患者接受常规药物治疗,观察组患者在此基础上加用阿戈美拉汀片,两组患者均持续治疗8周。比较两组患者的多导睡眠监测(PSG)指标、汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、匹兹堡睡眠指数量表(PSQI)、艾普沃斯嗜睡量表(ESS)、血清雌二醇(E2)、泌乳素(PRL)、黄体生成素(LH)水平。结果观察组治疗后的卧床时间、睡眠潜伏期、睡后清醒时间短于对照组,睡眠总时间、快速眼动潜伏期长于对照组,睡眠效率高于对照组,清醒次数少于对照组,差异有统计学意义(P<0.05)。观察组治疗后的HAMD、SDS、PSQI、ESS评分低于对照组,差异有统计学意义(P<0.05)。观察组治疗后的E2水平高于对照组,PRL水平低于对照组,差异有统计学意义(P<0.05),两组患者治疗前后组间组内的LH比较,差异无统计学意义(P>0.05)。结论双相抑郁发作伴睡眠节律紊乱患者以阿戈美拉汀治疗能够有效改善患者睡眠质量,减轻嗜睡状况,并能改善雌激素水平,减弱抑郁状态。

Objective To investigate the effects of Agomelatine therapy on sleep quality,depressive mood and estrogen levels in patients with bipolar depression accompanied by disturbed sleep rhythm.Methods A total of 54 patients with bipolar disorder admitted to Department of Psychosomatic Medicine,Fuzhou Third Hospital from October 2021 to January 2023 were selected as the study objects.All patients were in a state of mild to moderate depression accompanied by sleep rhythm disturbance.They were divided into control group and observation group according to random number table method,with 27 patients in each group.The control group received conventional drug treatment,and the observation group was additionally given Agomelatine Tablets.Both groups received continuous treatment for 8 weeks.The levels of polysomnography(PSG),Hamilton depression scale(HAMD),self-rating depression scale(SDS),Pittsburgh sleep index scale(PSQI),Epworth sleepiness scale(ESS),serum estradiol(E2),prolactin(PRL)and luteinizing hormone(LH)were compared between the two groups.Results After treatment,the bed time,sleep latency and wake time after sleep in the observation group were shorter than those in the control group,the total sleep time and rapid eye movement latency were longer than those in the control group,the sleep efficiency was higher than that in the control group,and the wake times was less than that in the control group,the differences were statistically significant(P<0.05).HAMD,SDS,PSQI and ESS scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the level of E2 in observation group was higher than that in control group,and the level of PRL was lower than that in control group,the differences were statistically significant(P<0.05).There was no significant difference in LH between two groups before and after treatment(P>0.05).Conclusion Agomelatine therapy can effectively improve sleep quality,reduce drowsiness,improve estrogen levels and reduce depression in patients with bipolar depression accompanied by disturbed sleep rhythm.