帕罗西汀联合茴拉西坦治疗老年抑郁症的疗效分析

doi:10.3760/cma.j.cn441417-20241025-09026

摘要/Abstract

摘要：

目的　观察帕罗西汀联合茴拉西坦治疗对老年抑郁症患者认知功能及糖脂代谢紊乱的影响。方法　回顾性分析2020年3月至2024年2月安康市中心医院收治的85例老年抑郁症患者临床资料，按照不同治疗方法分为对照组（41例）和观察组（44例）。对照组男23例、女18例，年龄（71.43±4.26）岁；接受帕罗西汀治疗，口服，开始剂量为10 mg/d，3 d后增加至20 mg/d；之后酌情增加剂量，最大剂量≤40 mg/d。观察组男27例、女17例，年龄（72.58±4.87）岁，在对照组基础上联合茴拉西坦治疗，口服，每次100 mg，1次/d。两组均治疗8周。对比两组认知功能［蒙特利尔认知评估量表（MoCA）评分］、抑郁程度［汉密尔顿抑郁量表（HAMD）评分］、临床疗效、血清学指标、糖脂代谢指标及不良反应。统计学方法采用t检验、χ2检验。结果　治疗8周后，观察组的MoCA、HAMD评分分别为（27.10±0.45、6.37±1.02）分，对照组分别为（25.51±0.83、12.18±2.54）分，差异均有统计学意义（t=11.082、14.013，均P<0.001）；血清胶质细胞源性神经营养因子、5-羟色胺、去甲肾上腺素分别为（631.49±65.87、135.84±17.20、141.29±15.94）ng/L，对照组分别为（527.86±58.30、118.25±13.76、128.46±13.52）ng/L，差异均有统计学意义（t=7.659、5.182、3.987，均P<0.05）；两组糖化血红蛋白、低密度脂蛋白胆固醇、餐后2 h血糖、甘油三酯水平比较，差异均无统计学意义（均P>0.05）。观察组的治疗总有效率为93.18%（41/44），高于对照组的75.61%（31/41），差异有统计学意义（χ2=5.059，P=0.025）。两组不良反应总发生率差异无统计学意义（P>0.05）。结论　帕罗西汀联合茴拉西坦治疗老年抑郁症疗效确切，可改善患者认知功能，调节糖脂代谢紊乱与神经递质水平，且安全性可靠。

关键词: 抑郁症')"> 抑郁症, ')">不良反应 , , 帕罗西汀, , , 茴拉西坦, , , 老年人, , , 认知功能, , , 糖脂代谢, , , Objective　To observe the effects of paroxetine combined with aniracetam on cognitive function and glucose and lipid metabolism disorders in elderly patients with depression. Methods　A retrospective analysis was conducted on the clinical data of 85 elderly patients with depression treated at Ankang Central Hospital from March 2020 to February 2024. Patients were divided into a control group (41 cases) and an observation group (44 cases) based on different treatment methods. The control group included 23 males and 18 females, the age was (71.43±4.26) years old; they received paroxetine orally, starting at a dose of 10 mg/d, which was increased to 20 mg/d after 3 days, with optional dosage adjustments up to a maximum of 40 mg/d. The observation group included 27 males and 17 females, the age was (72.58±4.87) years old; they received aniracetam orally at a dose of 100 mg once daily, in addition to paroxetine treatment. Both groups were treated for 8 weeks. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, depression severity was evaluated using the Hamilton Depression Scale (HAMD), and clinical efficacy, serological indicators, glucose-lipid metabolism indicators, and adverse reactions were compared. Statistical methods included t tests and χ² tests. Results　After 8 weeks of treatment, the MoCA and HAMD scores in the observation group were (27.10±0.45) and (6.37±1.02) points, respectively, compared to (25.51±0.83) and (12.18±2.54) points in the control group, with statistically significant differences (t=11.082, and 14.013, both P<0.001). Serum levels of glial cell-derived neurotrophic factor, serotonin, and norepinephrine were (631.49±65.87, 135.84±17.20, 141.29±15.94) ng/L in the observation group, compared to (527.86±58.30, 118.25±13.76, 128.46±13.52) ng/L in the control group, with statistically significant differences (t=7.659, 5.182, and 3.987, all P<0.05). There were no statistically significant differences between the two groups in terms of hemoglobin A1c, low-density lipoprotein cholesterol, postprandial 2-hour blood glucose, and triglyceride levels (all P>0.05). The total effective rate in the observation group was 93.18% (41/44), higher than the control group's 75.61% (31/41), with a statistically significant difference (χ²=5.059, P=0.025). The overall incidence of adverse reactions was not statistically significant between the two groups (P>0.05). Conclusion　The combination of paroxetine and aniracetam is effective in treating elderly depression, improving cognitive function, regulating glucose-lipid metabolism disorders and neurotransmitter levels, and demonstrating reliable safety.

Key words: Depressive disorder, , Paroxetine, , Aniracetam, , The aged, , Cognitive function, , Glucose and lipid metabolism, , Adverse reactions

李岩赵丽敏曲姗姗.

帕罗西汀联合茴拉西坦治疗老年抑郁症的疗效分析 [J]. 国际医药卫生导报, 2025, 31(9): 1544-1548.

Li Yan, Zhao Limin, Qu Shanshan.

Effects of paroxetine combined with aniracetam on glycolipid metabolism in elderly patients with depression [J]. International Medicine and Health Guidance News, 2025, 31(9): 1544-1548.

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