米氮平治疗抑郁症患者体重变化与疗效的相关性研究

摘要

目的：探讨抑郁症患者服用米氮平治疗后体重变化与其疗效的相关性。方法55例抑郁症患者接受米氮平单一抗抑郁药物治疗，开放性观察12周，以HDRS－17评价疗效，于基线及治疗后第一、二、四、八、十二周末重复测量体质量和HDRS－17评分，对连续性数据采用重复测量资料方差分析、Pearson相关分析和 ROC 分析。结果治疗12周后，患者平均体重增加值为（3．4±0．4） kg，HDRS－17总分明显改善（ F ＝893．14，P＝0．000），体重增加（F＝2．43，P＝0．035），差异均有统计学意义。治疗4周后，患者体重增加与量表减分率之间呈弱相关（r＝0．270～0．306，P＝0．044～0．022），但抑郁症状的早期改善对终点体重增加没有预测价值（AUC＝0．64〔0．48－0．79〕）。结论米氮平所致患者体重增加与疗效呈弱相关相关，应注意相关健康教育以免影响患者的服药依从性。%ABSTRACT:OBJECTIVE To evaluate the correlation between body weight change and mirtazapine treatment outcome in patients with depression.METHODS The 12-week,open-label clinic trial included 55 eligible patients with depression.All received mirtazapine monotherapy, and efficacy was assessed by 17-item Hamilton Depression Rating Scale (HDRS-17).HDRS-17 score and body weight were measured at baseline and week 1,2,4,8,12 lat-er.Weight changes and treatment outcomes were respectively analyzed by repeated-measures ANOVA, correlations between them were computed by Pearson Correlations procedure, and ROC analysis was performed to estimate the predictive value of early improvement on depressive symptom at week 2 prognosticating final weight gain at week 12.RESULTS After 12-week treatment,there was a significant elevation of body weight ( F=893.14,P=0.000) , with an average increase of (3.4 ±0.4) kg.Meanwhile,there was also a significant improvement on HDRS-17 total scores (F=2.43,P =0.035).A markedly correlations between them existed,with a weak value of r =0.270 ~0.306 (P=0.044~0.022).However,early improvement on depressive symptom failed to predict final weight gain at week 12 ( AUC=0.55〔0.49~0.62〕) .CONCLUSIONS A moderate negative correlation between weight in-crease and treatment outcome is found in depressed patients treated with mirtazapine,indicating the importance of healthy education on body weight control to enhance medication compliance.