执行功能对SSRI类抗抑郁剂疗效的预示作用(1)
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【摘要】目的 了解抑郁症患者治疗前执行功能对选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitor, SSRI)抗抑郁治疗效果的预示作用。方法 研究对象为广州市精神病医院门诊及住院的抑郁症患者，符合DSM-IV的抑郁发作诊断标准。用一组神经心理学检查评估治疗前抑郁症患者的执行功能，采用SSRI类抗抑郁药以有效治疗量治疗6周，以汉密尔顿抑郁量表减分率评估疗效。结果 入组46例，脱落6例，完成患者中21例治疗有效，19例治疗无效。有效组与无效组的年龄、性别、受教育程度、总病程、治疗前汉密尔顿抑郁量表评分及各因子分均无显著性差异；治疗前有效组威斯康辛卡片分类测验的分类数[(3.8±1.1)类]多于无效组[(3.0±1.2)类]，威斯康辛卡片分类测验的随机错误数[(10.2±5.6)个]、汉诺塔测验的平均计划时间[(7.5±2.4)秒]分别少于无效组[(14.7±6.0)个]、[(9.6±3.5)秒]，差异均有统计学意义(P均<0.05)；两组连线测验、言语流畅性测验的成绩差异无统计学意义(P均>0.05)。结论 多样性概念、预测力及计划能力等执行功能较好的抑郁症患者采用SSRI类抗抑郁药物治疗的疗效可能较好。
【关健词】抑郁症 执行功能 SSRI 疗效 预示作用
中图分类号：R971文献标识码：B文章编号：1005-0515(2010)11-025-03
The predictor of executive function in depressed patients to antidepressant efficacy of SSRI
XU Guiyun, RAO Dongping, DANG Yamei, OUYANG Huiyi
(Psychiatric Hospital, Guangzhou 510370)
【Abstract】Objective To investigate prediction of treatment response in depressed patients from baseline executive function. Methods Wisconsin Card Sorting Test (WCST), trail making tests (A, B) and verbal fluency test (animals) were made to assess the executive function in patients with major depression that met DSM-IV criterion. They were received selective serotonin reuptake inhibitor(SSRI) with effective therapeutic dose for 6 weeks. Severity of depressive symptoms was assessed using 17-HAMD. Operation definitions of antidepressant response were classified according to 17-HAMD scores. Results46 subjects were recruited at the Guangzhou psychiatric hospital. During the study, 6 patiets withdrawed and 21 cases of patients obtained the treatment effective, 19 cases failed. Age, gender, educational level, total duration, Hamilton depression scale score between effective group with ineffective group were not significantly different. The classification number of WCST in the effective group[(3.8±1.1)sorts] was more than that in ineffective group[(3.0±1.2) sorts], the random errors of WCST[(10.2±5.6) piece], the average planning time of the Tower of Hanoi test[(7.5±2.4) second] in the effective group was less respectively than that in ineffective one[(14 ......
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