作者：彭菊意 王艳琼 徐 勇 孙俊伟 孙宁 张克让
【摘要】 目的 探讨重性抑郁症患者的生存质量及其与氟西汀治疗的关系。方法 本研究采用病例对照研究的方法，测量17项汉密顿抑郁量表（HAMD）、简明健康状况问卷（SF-36）和不良反应量表（TESS）。患者均使用氟西汀治疗6周，治疗前后分别进行上述量表的评定。均数间比较采用t检验和ANOVA分析，氟西汀临床疗效与生存质量的改善进行Pearson相关分析。结果 （1）病例组（治疗前和治疗后）生存质量显著低于正常对照组（P＜0.01）。（2）与治疗前相比，治疗6周后病例组SF-36各因子分均有显著增高（P＜0.01～0.05）。（3）HAMD减分率与生活质量呈一定正相关性（P＜0.01～0.05）。同时，药物不良反应对生活质量也有一定的影响，有不良反应组生理功能（PF）和精力（VT）因子分显著低于无不良反应组（P≤0.05）。结论 重性抑郁症患者生存质量显著下降，氟西汀在6周内可以显著提高重性抑郁症患者的生存质量，但尚未恢复到正常人群水平。患者生存质量的改善与临床疗效呈一定正相关，同时也受药物不良反应及其他因素的影响。
【关键词】 重性抑郁症 生存质量 氟西汀 影响因素
［Abstract］ Objective To investigate the life quality of major depression patients and the influence of fluoxetine on life quality in major depression.Methods We used the method of case-control study. HAMD,SF-36 and TESS were used to evaluate the depressed symptoms,life qualities and side reaction.All patients were given six-week therapies of fluoxetine and assessed with above scales before and after therapy.T test and ANOVA were used to compare means between groups.The Pearson correlation analysis was done between clinical effect of fluoxetine and improvement of life quality.Results （1）Life qualities of patients （before and after treatment） were significantly lower than normal group.（2）Six-week treatment later,each factor’s score of SF-36 had a significant difference compared with the score before therapy （P<0.01～0.05）.（3）There was a certain direct correlation between HAMD reductive ratio and life quality （P＜0.01～0.05）.In addition,side reactions were also influence the life quality.The scores of PF and VT in side reactions group were lower than those of group without side reactions. Conclusion Life quality of major depression decreases significantly. Fluoxetine can improve the life quality of patients notably in six weeks,but can not make the life quality get the normal level in short term.There is a certain positive correlation between the effect of fluoxetine and improvement of life quality in patients. Meanwhile life quality is also influenced by other factors such as side reactions of drug and so on.
［Key words］ major depression;quality of life;fluoxetine;influential factor
抑郁症是一类严重危害人类身心健康的疾病，它具有高发病率、高致残率、高经济负担的特点，严重影响了患者的生存质量。对于其治疗，不仅要从症状上得到改善，更重要的是使患者的生活质量得到提高。新型抗抑郁药物如SSRI（选择性5-羟色胺再摄取抑制剂）类药物不仅有好的抗抑郁效果，而且使患者的生存质量有所改善［1～4］。有关重性抑郁症患者生存质量的研究，国内外报道较少。本文通过对重性抑郁症患者治疗前后生存质量与正常对照的比较，探讨重性抑郁症患者的生存质量及其与药物治疗之间的关系。