西酞普兰治疗儿童抑郁及情绪障碍临床探究.docVIP

西酞普兰治疗儿童抑郁及情绪障碍临床探究 　 作者：郭华 杨长虹 郭平 【关键词】 儿童；抑郁；情绪障碍；西酞普兰 　　【摘要】 目的 观察西酞普兰治疗儿童抑郁和情绪障碍的疗效及安全性。 方法 对23例儿童抑郁和情绪障碍患者给予西酞普兰治疗，初始剂量10mg#12539;d-1,1w后视病情逐渐增加剂量，最高剂量≤50mg#12539;d-1，平均剂量25±5.69mg#12539;d-1，疗程8w。对存在严重失眠症状者酌情使用苯二氮艹[]卓类药物。于治疗前及治疗第4、8w末采用艾氏儿童行为量表评定临床疗效，副反应量表评定不良反应。艾氏儿童行为量表减分率≥60%为有效，＜60%为无效。以艾氏儿童行为量表＜5分为临床痊愈。 结果 治疗第4、8w末艾氏儿童行为量表评定总分、抑郁、焦虑、强迫因子分均较治疗前有显著下降，差异有极显著性（P均＜0.01）。常见不良反应有体重增加，轻度胃肠道反应。 结论 西酞普兰治疗儿童抑郁和情绪障碍疗效显著，安全性高。 　　【关键词】 儿童；抑郁；情绪障碍；西酞普兰 　　Clinical studies of citalopram in children with depression and emotional disorder 　　【Abstract】 Objective To explore the curative effects and safety of citalopram in children with depression and emotional disorder. Methods 23 children with depression and emotional disorder were treated with citalopram, initial dose was 10mg/d which gradually increased after one week, maximal ≤ 50mg/d and mean 25± 5.69mg/d for 8 weeks. The children who had severe insomnia were given benzodiazepines. Curative effects and adverse reactions were assessed with the Child Behavior Checklist(CBCL) and Treatment Emergent Symptom Scale(TESS) before treatment and at the ends of 4th and 8th week of treatment, respectively. The scorereducing rate of the CBCL ≥ 60% was effective and lt; 60% ineffective. The score of the CBCL lt; 5 was clinical recovery. Results Compared with pretreatment, the total score and scores of depression, anxiety and compulsion significantly decreased at the ends of 4th and 8th week, difference was the most significant( all Plt;0.01). Main adverse reactions were weight gain and mild gastrointestinal reactions. Conclusion Citalopram has notable curative effect and high safety in children with depression and emotional disorder. 　　【Keywords】 Children; depression; emotional disorder; citalopram 　　西酞普兰是选择性5羟色胺（5HT）再摄取抑制剂（SSRIs）中对5HT选择性最强的一种新型抗抑郁药物［1］，临床应用效果较为肯定，且副作用小［2~6］，但应用于儿童的报告较少。本研究应用西酞普兰对儿童抑郁和情绪障碍进行治疗观察，现将结果报告如下。 　　1 对象与方法 　　1.1 对象 随机选取河南省驻马店市精神病医院住院的23例儿童抑郁和情绪障碍患者为研究对象。入组标准：（1）符合《中国精神障碍分类与诊断标准》第3版（CCMD3）情感障碍的单次发作或反复发作抑郁症、双向情感障