新型抗抑郁药物治疗冠心病并发抑郁症的安全性分析

摘要

Objective To evaluate the safety of new-generation of antidepressants and amitriptyline in the treatment of depression in patients with coronary heart disease (CHD). Methods A total of 194 patients with first-episode depression with CHD were divided into amitriptyline group(n=40), venlafaxine group(n=40), mirtazapine group(n=48)and escitalo⁃pram group(n=66). The blood routine test, liver function, blood lipids and blood glucose (GLU) were monitored after treat⁃ment for six weeks, and which were compared before and after treatment. Results The levels of white blood cells (WBC) and neutrophil count (NE) were significantly lower in amitriptyline group after 6-week treatment (P<0.05), but the levels of acid alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (T-CHO) and GLU were significant⁃ly increased after treatment than those before treatment (P<0.05). The levels of WBC, NE and GLU were significantly de⁃creased in venlafaxine group after 6-week treatment (P<0.05). The levels of ALT, AST, low density lipoprotein (LDL) were significantly increased in mirtazapine group after six-week treatment (P<0.05). In escitalopram group, the level of three ac⁃yl glycerin (TG) was significantly increased after six-week treatment than before treatment ( P<0.05). There was a signifi⁃cant difference in AST change after treatment between venlafaxine group and mirtazapine group (P<0.05). There was a sig⁃nificant decrease in WBC in amitriptyline group than that of mirtazapine group after six-week treatment ( P<0.05). There was a significant decrease in NE in amitriptyline group than that of mirtazapine group and escitalopram group ( P<0.05). The increase level of AST was significant higher in amitriptyline group than that of venlafaxine group (P < 0.05). Conclusion Three different kinds of new-generation of antidepressants have fewer influence in routine blood test, liver function, blood lipids and blood glucose than those of amitriptyline in the treatment of depression in patients with CHD.%目的：评价部分新型抗抑郁药物及阿米替林治疗冠心病并发抑郁症的安全性。方法将194例冠心病首发抑郁症患者按所服药物分为阿米替林组（n=40）、文拉法辛组（n=40）、米氮平组（n=48）、艾司西酞普兰组（n=66），分别监测4种药物治疗6周后血常规、肝功能、血脂和血糖，并与治疗前进行比较。结果阿米替林组治疗6周后白细胞（WBC）、中性粒细胞计数（NE）显著低于治疗前（P＜0.05），丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆固醇（T-CHO）及血糖（GLU）较治疗前显著升高（P＜0.05）；文拉法辛组治疗6周后WBC、NE及GLU显著降低（P＜0.05）；米氮平组治疗6周后ALT、AST、低密度脂蛋白（LDL）显著高于治疗前（P＜0.05）；艾司西酞普兰组治疗6周后三酰甘油（TG）显著高于治疗前（P＜0.05）。文拉法辛组治疗后AST低于米氮平组（P＜0.05）。阿米替林组治疗后WBC下降显著高于米氮平组（P＜0.05），NE下降显著高于米氮平组及艾司西酞普兰组（P＜0.05），AST升高显著高于文拉法辛组（P＜0.05）。结论3种新型抗抑郁药物对冠心病并发抑郁症患者的血常规、肝功能、血脂、血糖影响均较阿米替林小。