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帕金森病伴抑郁患者经氟西汀联合奥氮平治疗后认知功能及P300的变化分析

  • 官长富,李德川,李先萍,钟丽

* 通信作者: 官长富, 单位:四川省内江市第二人民医院精神科

摘要

摘要
目的 探究帕金森伴抑郁患者经氟西汀及奥氮平联合治疗后其认知功能及P300的变化。

方法 选取2015年1月-2016年11月于本院精神科确诊并接受住院治疗的帕金森伴抑郁患者123例,将其按照入院顺序编号,并按随机数字表法分为对照组(n=61)与实验组(n=62),对照组患者采用氟西汀口服治疗,实验组患者在对照组的基础上联合小剂量奥氮平治疗,2组均连续治疗8周。采用汉密尔顿抑郁量表(HAMD)评估2组患者治疗前后抑郁状态,统计2组临床疗效;另采用简易精神状态测量量表(MMSE)和蒙特利尔认知功能评估量表(MoCA)评估2组治疗前后认知功能的变化;采用肌电诱发电位仪检测2组治疗前后P300波潜伏期及波幅。

结果 与治疗前比较,治疗后2-8周,2组HAMD评分均逐渐降低(P<0.01),且实验组治疗后2周及2组治疗后4-8周的HAMD评分显著低于治疗前(P<0.01),且治疗后2-8周实验组均显著低于对照组(P<0.01);治疗后8周实验组临床总有效率(70.97%)显著高于对照组(32.79%)(P<0.01);治疗后8周2组患者的MoCA评分及实验组患者的MMSE评分较治疗前均有明显升高(P<0.01),且实验组MoCA及MMSE评分明显高于对照组(P<0.01);治疗后8周2组患者P300波潜伏期较治疗前有明显缩短,P300波幅较治疗前有明显增加(P<0.05或P<0.01),且2组差异显著(P<0.01)。

结论 以氟西汀联合奥氮平治疗帕金森病伴抑郁患者可显著改善其抑郁症状,同时还可有效提高患者认知,调节患者P300认知电位,临床疗效显著优于氟西汀单用。

关键词:关键词 帕金森病伴抑郁; 氟西汀; 奥氮平; 抑郁; 认知; P300

ABSTRACT

Abstract
Objective To explore the changes of cognitive function and P300 after fluoxetine combined with olanzapine in the treatment of parkinson's disease with depression.

Methods A total of 123 cases of parkinson's disease with depression patients in psychiatry department of our hospital from Jan. 2015 to Nov. 2016 were selected and divided randomly into control group (n=61) and experiment group (n=62) according to the random number table method. Control group were treated with fluoxetine, and experiment groupwere treated combined with small dose olanzapine, 2 groups were treated for 8 weeks. Assessed the depressive state by (Hamilton depressive Scale) HAMD before and after treatment, statisticsed tghe clinical efficacy; assessed the changes of cognitive function before and after treatment by (mini-mental state examination) MMSE and Montreal Cognitive Assessment (MoCA), and detected the changes of P300 incubation and amplitude by electrical trigger potentiometer.

Results Compared with before treatment, the HAMD scores gradually decrease 2-8 weeks after treatment, 2 weeks after treatemnt of experiment group and 4-8 weeks after treatment of 2 groups were lower than before treatment (P<0.01), and experiment group was lower than control group 2-8 weeks after treatment (P<0.01); The clinical tatal efficacy of experiment group 8 weeks after treatment (70.97%) was hiher than control group (32.79%) (P<0.01); The MoCA scores of 2 groups and the MMSE score of experiment group increased significantly compared with before treatemnt 8 weeks after treatment (P<0.01), and the MoCA and MMSE scores of experiment group were higher than that of control group (P<0.01); The P300 amplitude shortened significantly compared with before treatment, and the P300 incubation increased significantly compared with before treatment 8 weeks after treatment (P<0.05 or P<0.01), and the difference between 2 groups was significant (P<0.01).

Conclusion   Fluoxetine combined with olanzapine can improve the depressive state of parkinson's disease with depression patients, increase the cognitive function, adjust the P300 Cognitive potential, the clinical efficacy is superior to fluoxetine alone.

Key words: Key words parkinson's disease with depression; fluoxetine; olanzapine; depressive; cognitive; P300

引用本文 / How to Cite This Article

官长富,李德川,李先萍,钟丽.帕金森病伴抑郁患者经氟西汀联合奥氮平治疗后认知功能及P300的变化分析[J]. 国际精神病学杂志, 2018, 45(4): 661-663

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