阿戈美拉汀分别联合文拉法辛、安慰剂对老年抑郁症患者BDNF、5-HT、FGF-22、ACTH水平的影响

Effects of agomelatine combined with venlafaxine and placebo on levels of BDNF,5⁃HT,FGF⁃22 and ACTH in elderly patients with depression

目的 分析阿戈美拉汀分别联合文拉法辛、安慰剂对老年抑郁症患者脑源性神经生长因子(BDNF)、5-羟色胺(5-HT)、成纤维细胞生长因子-22(FGF-22)和促肾上腺皮质激素(ACTH)水平的影响。方法 选取2022年1月至2023年6月衡水市第七人民医院收治的老年抑郁症患者110例,采用随机数字表法分为A组(阿戈美拉汀联合安慰剂,n=55)以及B组(阿戈美拉汀联合文拉法辛,n=55),均连续进行治疗12周。比较两组治疗12周后临床疗效,比较两组治疗前、治疗12周后血清BDNF、5-HT、FGF-22、ACTH水平、心率变异性指标、韦氏成人记忆量表(WMS-RC)评分,比较两组不同时间点汉密顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)评分。结果 B组的临床总有效率高于A组,差异有统计学意义(P<0.05)。与治疗前比较,两组血清ACTH水平均降低,且B组低于A组,血清BDNF、5-HT、FGF-22水平、频域总值(TP)、正常RR间期标准差(SDNN)、高频(HF)、低频(LF)、WMS-RC各个评分均升高,且B组高于A组,差异有统计学意义(P<0.05)。与治疗前比较,治疗3~12周后两组HAMD、PSQI评分均逐渐降低,且B组低于A组,差异有统计学意义(P<0.05)。结论 应用阿戈美拉汀联合文拉法辛能够改善老年抑郁症患者心率变异性,调节患者神经系统相关因子水平提高患者认知功能的同时疗效显著。

Objective To analyze the effects of agomelatine combined with venlafaxine and pla-cebo on the levels of brain-derived nerve growth factor(BDNF),serotonin(5-HT),fibroblast growth factor-22(FGF-22)and adrenocorticotropic hormone(ACTH)in elderly patients with depression.Methods 110 elderly patients with depression were admitted to the Seventh Peoples Hospital of Hengshui City from January 2022 to June 2023.They were divided into two groups:group A(agomelatine combined with a placebo,n=55)and group B(agomelatine combined with venlafaxine,n=55)using the random number table method.All patients received continuous treatment for 12 weeks.The clinical efficacy after 12 weeks of treatment,levels of serum BDNF,5-HT,FGF-22,ACTH,heart rate variability index,scores of the Wechsler Adult Memory Scale(WMS-RC)before and after 12 weeks of treatment,Hamilton Depression Scale(HAMD)and Pittsburgh Sleep Quality Index(PSQI)at different time points were compared between the two groups.Results The clinical to-tal effective rate in group B was higher than that in group A,and the difference was statistically significant(P<0.05).Compared to before treatment,the levels of serum ACTH in both groups decreased.Additionally,the lev-els of serum BDNF,5-HT,FGF-22,total value of frequency domain(TP),standard deviation of normal RR interval(SDNN),high frequency(HF),low frequency(LF)and WMS-RC all increased in group B,and the differences were statistically significant(P<0.05).Compared to before treatment,after 3 to 12 weeks of treat-ment,the scores of HAMD and PSQI in both groups gradually decreased.The difference in group B was lower than that in group A(P<0.05).Conclusion The combination of agomelatine and venlafaxine could enhance the heart rate variability,regulate levels of nervous system related factors,improve sleep quality,reduce depres-sion,and enhance cognitive function.