目的 探究草酸艾司西酞普蘭聯(lián)合喹硫平治療雙相情感障礙（BPD）抑郁發(fā)作的臨床療效。方法 選取2020年5月—2022年5月新疆維吾爾自治區(qū)人民醫(yī)院收治的104例BPD抑郁發(fā)作患者，隨機(jī)數(shù)字表法將患者以1∶1比例分為對照組和治療組，每組各52例。對照組患者口服富馬酸喹硫平片，初始劑量50 mg/次，2次/d；每日增加50～100 mg，直至300～600 mg/d。治療組在對照組基礎(chǔ)上口服草酸艾司西酞普蘭片，初始劑量10 mg/次，1次/d，服用1周后根據(jù)情況劑量調(diào)整為20 mg/次，1次/d。兩組患者均治療8周。觀察兩組患者臨床療效，比較治療前后兩組患者漢密爾頓抑郁量表（HAMD）評分和楊氏躁狂量表（YMRS）評分，血清白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-1β（IL-1β）、巨噬細(xì)胞移動抑制因子（MIF）、過氧化氫酶（CAT）、超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽過氧化物酶（GSH-Px）水平。結(jié)果 治療后，治療組總有效率為88.46%，較對照組的71.15%明顯升高（P＜0.05）。治療后，兩組患者HAMD評分均較治療前降低（P＜0.05），且治療組較對照組降低更顯著（P＜0.05）。治療后，兩組患者血清IL-6、IL-1β、MIF和MDA水平均較治療前明顯降低，而血清SOD、CAT、GSH-Px水平均較治療前明顯升高（P＜0.05），且治療組血清學(xué)指標(biāo)改善水平明顯好于對照組（P＜0.05）。結(jié)論 草酸艾司西酞普蘭聯(lián)合喹硫平治療BPD抑郁發(fā)作患者效果顯著，可有效改善抑郁癥狀，抑制機(jī)體炎癥，調(diào)節(jié)氧化應(yīng)激狀態(tài)，不增加轉(zhuǎn)躁風(fēng)險。

Objective To investigate the clinical efficacy of escitalopram oxalate combined with quetiapine in treatment of depressive episode of bipolar disorder. Methods A total of 104 patients with BPD depressive episode admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from May 2020 to May 2022 were selected. The patients were divided into control group and treatment group with a ratio of 1:1 by random number table method, with 52 cases in each group. Patients in the control group were po administered with Quetiapine Fumarate Tablets, the initial dose was 50 mg/time, twice daily, and the daily increase was 50 — 100 mg until 300 — 600 mg/d. Patients in the treatment group were po administered with Escitalopram Oxalate Tablets on the basis of the control group, the initial dose was 10 mg/time, once daily, and after a week, the dose was adjusted to 20 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluation was evaluated, and the scores of HAMD and YMRS, the levels of serum IL-6, IL-1β, MIF, SOD, CAT, GSH-Pxand MDA in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 88.46%, which was significantly higher than that of the control group (71.15%, P < 0.05). After treatment, the HAMD scores of patients in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of serum IL-6, IL-1β, MIF and MDA in two groups were significantly lower than those before treatment (P < 0.05), while the levels of serum SOD, CAT and GSH-Px were significantly higher than those before treatment (P < 0.05), and the improvement level of serological indexes in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Escitalopram oxalate combined with quetiapine is effective in treatment of depressive episode of bipolar disorder. It can effectively improve depressive symptoms, inhibit inflammation, regulate oxidative stress, and does not increase the risk of becoming irritable.

R971

新疆維吾爾自治區(qū)自然科學(xué)基金資助項目（2021D01C157）