艾司西酞普兰治疗儿童和青少年抑郁症的Meta分析

A meta-analysis of escitalopram in treatment of depression in children and adolescents

目的系统评价艾司西酞普兰治疗儿童和青少年抑郁症的疗效与安全性。方法计算机检索PubMed、 Embase、 Cochrane图书馆、中国知网、维普全文数据库、中国生物医学文献数据库和万方数据库中关于艾司西酞普兰治疗儿童和青少年抑郁症疗效与安全性的随机对照试验(RCT),采用Cochrane协作网推荐的RevMan 5.3软件对各效应指标进行Meta分析。结果共纳入3项RCT,合计888例儿童和青少年患者。Meta分析结果显示:艾司西酞普兰组有效率显著高于安慰剂组(OR=1.61, 95%CI:1.23~2.11, P=0.000 5),但患者耐受性显著低于安慰剂组(OR=3.62, 95%CI:1.18~11.05, P=0.02);在安全性方面, 2组患者不良反应发生率差异无显著意义(OR=1.14, 95%CI:0.84~1.55, P=0.41),患者自我伤害行为或想法发生率差异亦无显著意义(OR=1.08, 95%CI:0.55~2.13, P=0.83)。结论艾司西酞普兰治疗儿童、青少年抑郁症的疗效优于安慰剂,其不良反应和自我伤害发生率与安慰剂相当。

AIM To systematically evaluate the efficacy and safety of escitalopram in the treatment of children and adolescents with depression.METHODS Randomized controlled trials(RCTs)of escitalopram in the treatment of depression in children and adolescents were searched in PubMed,Embase,Cochrane Library,CNKI,VIP,CBM and Wangfang database by computer.The meta-analysis was carried out by using RevMan5.3 software.RESULTS A total of 3 RCTs involving 888 patients were included for the final analysis.The response rate was higher in the escitalopram group than that of the placebo group(OR=1.61,95%CI:1.23-2.11,P=0.000 5),but the patient tolerance was significantly lower in the escitalopram group than that of the placebo group(OR=3.62,95%CI:1.18-11.05,P=0.02).There was no significant difference in the rate of adverse reactions(OR=1.14,95%CI:0.84-1.55,P=0.41)and the incidence of self-harm behaviors or thoughts(OR=1.08,95%CI:0.55-2.13,P=0.83)between the two groups.CONCLUSION Escitalopram is more effective than placebo in treating children and adolescents with depression,and there was no significant difference in rates of adverse reactions and self-harm.