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[目的]比较米氮平和舍曲林治疗首发抑郁症对认知功能的影响.[方法]198例首发抑郁症患者随机予以米氮平(n=98)与舍曲林(n=100)治疗,疗程6周.采用汉密尔顿抑郁量表(HAMD-17)评定疗效;采用威斯康星卡片分类测验(WCST)、连线测验(TMT)、词语流畅作业(VF)、数字符号和数字广度测验评定认知功能.[结果]治疗6周后,米氮平组的有效率为82.7％,舍曲林组的有效率为81.0％,两组比较差异无统计学意义(P＞0.05).治疗6周末,两组的WSCT正确数、分类个数较治疗前均有提高,错误数、持续错误数均有减少(P＜0.05);两组的TMT连线时间均较治疗前明显减少(P＜0.05);两组的VF总数均较治疗前明显增加(P＜0.05);两组的数字符号均较治疗前明显增加(P＜0.05);两组的数字广度治疗前后比较无显著性差异(P＞0.05).米氮平组患者在治疗6周后,WSCT非持续错误数降低、TMT-A连线时间减少、VF总数增加均较舍曲林组更为显著(P＜0.05).[结论]米氮平与舍曲林治疗抑郁症疗效相当,米氮平改善抑郁症伴发的认知功能障碍更为明显.“,”[Objective]To compare the efficacy of mirtazapine and sertraline on the cognitive function in first-episode depression patients.[Method]A total of 198 first-episode major depression patients were randomly assigned to mirtazapine (n =98)or sertraline (n =100)for 6 weeks.The efficacies of patients were assessed by HAMD (Hamilton Depression Scale) and the cognitive functions were evaluated with Wisconsin card sorting test(WCST),trail marking test(TMT),verbal fluency task(VF),digital symbol and digital span[Resuits] After 6 weeks of treatment,the effective rate of mirtazapine and sertraline were respectively 82.7％ and 81.0％.There was no significant difference between two groups(P ＞0.05).After 6-weeks treatment,the two group patients had improvement in WSCT (in terms of right response numbers,classification,errors,continuous errors),reduced TMT times,and increased VF plus numbers and digital symbol(P ＜0.05).However,the digital span in two group patients had not obvious improvement after treatment(P ＞0.05).In the 6th weekend of treatment,the WSCT random errors and TMT-A times in the mirtazapine group were significantly lower than in the sertraline group(P ＜0.05).The VF numbers in the mirtazapine group were significantly higher than sertraline group(P ＜0.05).[Conclusion] Mirtazapine is as effective as sertraline,and is superior in improving cognitive functions than sertraline.