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目的旨在评估引起这些精神心理症状的易感因素并分析艾司西酞普兰干预这些症状的效果。方法 59例慢性丙型病毒性肝炎患者,经聚乙二醇干扰素联合利巴韦林的抗病毒治疗,12周时由精神科医师使用DSM-IV标准进行评估,并指导患者使用SCL-90量表自评。对于符合重度抑郁标准者进行艾司西酞普兰干预治疗,在用药后4周,8周时再次行SCL-90测评。结果中重度抑郁的易感因素有:男性,1b基因型,感染途径为静脉药瘾。干扰素相关中重度抑郁的发病率为32.2%。其他精神症状,如:敌对、焦虑、人际关系敏感各因子的发生率为分别为19.7%,9.2%,5.26%。使用艾司西酞普兰治疗后4周及8周,患者的SCL-90总分,敌对、焦虑、抑郁、人际关系敏感各因子得分显著下降。结论干扰素引发的精神症状在我国丙型肝炎的患者中发生率较高,应做常规的精神症状评估,特别注意对静脉药瘾感染人群的评估,及时使用艾司西酞普兰对于干扰素引发的精神症状有较好的疗效。
The purpose is to assess the predisposing factors that cause these psychosocial symptoms and to analyze the effect of escitalopram on these symptoms. Methods Fifty-nine patients with chronic hepatitis C were antivirally treated with pegylated interferon plus ribavirin and evaluated by psychiatrists at 12 weeks using the DSM-IV standard and were instructed to use the SCL-90 Scale self-assessment. For those who met the criteria of severe depression Escitalopram intervention treatment, again 4 weeks after treatment, 8 weeks again SCL-90 evaluation. The results of moderate to severe depression predisposing factors: male, 1b genotype, the route of infection for intravenous drug addiction. The incidence of moderate and severe interferon-related depression was 32.2%. Other psychiatric symptoms, such as: hostility, anxiety, interpersonal sensitivity of the various factors were 19.7%, 9.2%, 5.26%. At 4 weeks and 8 weeks after escitalopram treatment, scores of SCL-90, hostility, anxiety, depression and interpersonal sensitivity were significantly decreased. Conclusions The incidence of psychiatric symptoms induced by interferon is high in patients with hepatitis C in our country. It should be assessed by routine psychiatric symptoms, with special attention paid to the assessment of intravenous drug addicts and the timely use of escitalopram for interferon-induced The mental symptoms have a better effect.