目的：探讨低剂量奥氮平对5-羟色胺再摄取抑制剂（SSRIs）抗抑郁的增效作用及对抑郁障碍（MDD）患者心血管的安全性。方法：61例 MDD 患者随机分为研究组（29例）和对照组（32例），两组在 SSRI 治疗的基础上，研究组联合奥氮平5 mg/ d；疗程均为4周。治疗前后进行汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定及心率变异性（HRV）分析。结果：①治疗后两组 HAMD及 HAMA 评分较治疗前显著降低（P 均﹤0.01），且研究组 HAMA 评分显著低于对照组（P ﹤0.01）；两组间治疗前 HAMD 评分及治疗前后 HAMD 评分比较差异无统计学意义。②治疗后两组 HRV 指标中的正常 RR 间期标准差（SDNN）及高频功率（HF）显著升高（P 均﹤0.05），低频功率（LF）治疗前后差异无统计学意义；两组间 HRV 各项指标比较差异无统计学意义。结论：低剂量奥氮平对 SSRIs 具有一定的抗抑郁增效作用，短期使用对血管安全性没有影响。%Objective:To explore the low-dose olanzapine antidepressant synergy effect for selective se-rotonin reuptake inhibitors(SSRIs)and the influence of autonomic nervous function in patients with major de-pressive disorder(MDD). Method:Sixty-one MDD patients were randomly divided into syudy group(29 ca-ses)and control group(32 cases). On the basis of SSRI treatment in both groups,the syudy group was com-bined with low-dose olanzapine(5 mg/ d). The course in both groups was 4 weeks. Before and after treatment the patients were evaluated with Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)and an-alyzed with heart rate variability(HRV). Results:① The scores of HAMA and HAMD in the two groups af-ter treatment were significantly reduced than before treatment(all P ﹤ 0. 01);and score of HAMD in the study grouo was significantly lower than the control group(P ﹤ 0. 01). Between the two groups,the HAMD scores at before treatment and HAMD scores before and after treatment there were no statistically significant difference. ②In the two groups after treatment,the indices of HRV in the normal period of standard deviation between the RR (SDNN)and high frequency power(HF)were increased significantly(all P ﹤ 0. 05);the low frequency power (LF)there was no statistically significant difference before and after treatment. The difference of HRV indica-tors between the two group had no statistical significance. Conclusion:Low-dose olanzapine has certain anti-depressant synergistic effect for SSRIs;and short-term use has no effect on the safety of blood vessels.
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