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目的：调查老年难治性抑郁症患者的临床特征并对一线抗抑郁药的临床疗效进行对比分析。方法选择2010．1-2013．12我院住院治疗的60岁以上难治性抑郁症患者80例和20～40岁的非老年普通抑郁患者80例，使用汉密尔顿抑郁量表（ HAMD）对两组抑郁特征进行分析对比同时观察TCAs、SSRIs两类主要一线抗抑郁药对老年难治性抑郁患者的临床疗效。结果非老年组与老年组HAMD中激越性抑郁因子、焦虑反应因子无显著差异，老年组躯体症状因子（t＝29．85；P＜0．01）、迟滞性抑郁因子（t＝42．30；P＜0．01）与非老年组比较有显著差异；在老年难治性抑郁症治疗效果方面TCAs组治疗各周（1、2、4、8、12）与SSRIs组比较均有显著差异，效果明显优于SSRIs组：（t＝8．03，21．40，49．87，48．90，84．81；P＜0．01）。结论老年性难治性抑郁症具有其特殊临床特征，一线抗抑郁药物TCAs对老年性难治性抑郁的治疗效果明显优于SSRIs。“,”Objective To explore the clinical characteristics of elderly patients with treatment resistant depression and compare the efficacy of antidepressant .Methods 80 patients over 60 with treatment resistant depression and 80 normal depressives between 20-40 were measured by HAMD and the efficacy of TCAs and SSRIs were analyzed .Results There were no significant differences between the elderly patients and non -elderly patients in somatization and retarded depression (t=29.85,42.30;P<0.0).TCAs had better efficacy in 1,2,4,8,12 weeks of treatment in elderly with treatment resistant depression than SSRIs (t=8.03,21.40,49.87,48.90,84.81;P<0.01).Conclusion Treatment resistant depression in elderly has specific clinical characteristics and TCAs is better than SSRIs in the treatment of elderly with treatment resistant depression .