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3 种抗抑郁药对中老年慢性失眠伴抑郁情绪患者肝功能的影响
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R971+.3

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The Effect of three antidepressants on liver function in middle-aged and elderly patients with chronic insomnia and depression
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    摘要:

    目的?探讨曲唑酮、米氮平和阿戈美拉汀治疗中老年慢性失眠伴抑郁患者对肝功能的影响,为临床提供参考。 方法?选取 2010 年 1 月至 2019 年 12 月北京中西医结合医院收治的 109 例慢性失眠伴抑郁情绪的患者为研究对象进行回 顾性分析,根据使用药物的不同分为曲唑酮组(40 例)、米氮平组(37 例)和阿戈美拉汀组(32 例)。比较 3 组患者治 疗后谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)和总胆红素(TBIL)的变化情况,并对其干预方式和转归进行随访。 结果?米氮平组重度肝功能异常患者占比高于曲唑酮组、阿戈美拉汀组(P <0.05),阿戈美拉汀组患者肝功能异常发生 率显著高于曲唑酮组、米氮平组(P <0.05),3 组患者肝功能异常指标变化比较,差异无统计学意义(P >0.05);低剂 量使用时,阿戈美拉汀所致肝功能异常比例较高;高剂量使用时,米氮平所致肝功能异常的患者比例显著升高(P<0.05)。 结论?抗抑郁药对中老年患者肝功能存在一定的影响,在使用药物时应定期规律检测肝功能指标,确保患者用药安全。

    Abstract:

    Objective?To investigate the effect of trazodone, mirtazapine and agomelatine on liver function of middle-aged and elderly patients with chronic insomnia and depression, and to provide clinical reference. Methods?A total of 109 patients with chronic insomnia and depression admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine from January 2010 to December 2019 were retrospectively analyzed, and they were divided into trazodone group (40 cases), mirtazapine group (37 cases) and agomelatine group (32 cases) according to different drugs. The changes of alanine transaminase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in 3 groups were compared after treatment, and the intervention methods and outcomes were followed up. Results?Mirtazapine group of patients with severe abnormal liver function much higher than the trazodone group, agomelatine group (P < 0.05), the incidence of abnormal liver function in agomelatin group was significantly higher than that in trazodone group and mirtazapine group (P < 0.05), three groups of patients with abnormal liver function index changes, there was no statistically significant difference (P >0.05). The proportion of abnormal liver function induced by agomelatine was higher at low dose. The proportion of abnormal liver function induced by mirtazapine was significantly increased at high dose (P<0.05). Conclusion?Antidepressants have certain effects on the liver function of middle-aged and elderly people, so the liver function should be monitored regularly to ensure the safety of drug use.

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  • 在线发布日期: 2022-07-27
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