青岛大学医学院学报2017，Vol.53Issue(4)：396-399,406,5.DOI:10.13361/j.qdyxy.201704007
早期症状改善预测西酞普兰治疗重性抑郁症有效性及性别差异
PREDICTIVE VALUE OF EARLY SYMPTOM IMPROVEMENT FOR THE CLINICAL EFFECT OF CITALOPRAM IN TREATMENT OF MAJOR DEPRESSION AND ITS SEX DIFFERENCE
摘要
Abstract
Objective To investigate whether early symptom improvement can predict the outcome of patients with major depression treated with citalopram for 6 weeks,as well as the sex difference of predictive accuracy.Methods A total of 93 hospitalized patients with major depression were enrolled and divided into two groups according to sex.There were 39 patients in the male group and 54 patients in the female group.All patients were given oral citalopram 20 mg/d during week 1,and the dose of citalopram was gradually increased to 40 mg/d based on the patients' conditions.The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate the outcome at the end of weeks 0,1,2,4,and 6,and a reduction in MADRS score of ≥ 50％ was considered effective.The receiver operating characteristic (ROC) curve was used to analyze the reduction rate of MADRS score at the end of weeks 1,2,and 4 and determine the cut off values.Results At the end of weeks 1,2,and 4,the cut-off values of the reduction rate of MADRS score were 15.79％,37.84％,and 45.94％,respectively,with diagnostic sensitivities of 73.77％,78.69％,and 95.08％,diagnostic specificities of 71.87％,78.12％,and 87.50％,and areas under the ROC curve (AUCs) of 0.729,0.810,and 0.955,respectively.In the male group,the cut-off values of the reduction rate of MADRS score were 15.79％,37.84％,and 45.94％,respectively,at the end of weeks 1,2,and 4,with diagnostic sensitivities of 73.68％,78.95％,and 94.74％,diagnostic specificities of 70.00％,75.00％,and 85.00％,and AUCs of 0.711,0.808,and 0.929,respectively.In the female group,the cut-off values of the reduction rate of MADRS score were 15.79％,35.48％,and 45.16％,respectively,at the end of weeks 1,2,and 4,with diagnostic sensitivities of 73.81％,80.95％,and 95.24％,diagnostic specificities of 75.0％,83.33％,and 91.67％,and AUCs of 0.718,0.827,and 0.963,respectively.Conclusion Early symptom improvement in hospitalized patients with major depression can predict the late clinical effect of citalopram,with a higher predictive accuracy in female patients than in male patients.关键词
抑郁症/西酞普兰/治疗结果/性别因素Key words
depressive disorder/citalopram/treatment outcome/sex factors分类
医药卫生引用本文复制引用
王璐,姜祥智,谌利民,袁国桢..早期症状改善预测西酞普兰治疗重性抑郁症有效性及性别差异[J].青岛大学医学院学报,2017,53(4):396-399,406,5.基金项目
国家自然科学基金资助项目(81471354) （81471354）
