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目的:研究干扰素引起的抑郁样精神症状的特点、易感因素及药物干预效果。方法:73例慢性丙型病毒性肝炎患者,经干扰素联合利巴韦林抗病毒治疗,12周时使用SCL-90量表进行评分。对于中重度抑郁患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:干扰素相关的抑郁样精神症状以轻、中度为主,中、重度抑郁的易感因素有:男性,非输血途径感染(P<0.05)。干扰素相关中重度抑郁的发病率为21.9%,多表现为抑郁、焦虑、敌对和睡眠质量差,与对照组比较有统计学意义(P<0.05)。艾司西酞普兰能有效缓解抑郁、敌对、焦虑等精神症状,与治疗前比较有统计学意义(P<0.05),且无明显不良反应。结论:干扰素引发的抑郁障碍应被关注和重视,及早评估、诊断和药物干预有利于提高患者治疗依从性、安全性和综合疗效。
Objective: To study the characteristics of depression-like psychiatric symptoms caused by interferon, the predisposing factors and the effect of drug intervention. Methods: Seventy-three patients with chronic hepatitis C were treated with interferon plus ribavirin antiviral therapy and scored on SCL-90 at 12 weeks. Escitalopram interventional therapy for patients with moderate-severe depression, SCL-90 evaluation again 4 weeks, 8 weeks after treatment. Results: The predominant depression-like psychiatric symptoms associated with interferon were light and moderate. The predisposing factors of moderate and severe depression were male and non-blood transfusion pathways (P <0.05). The incidence of moderate and severe interferon-related depression was 21.9%, which was mostly depression, anxiety, hostility and poor quality of sleep, compared with the control group (P <0.05). Escitalopram can effectively alleviate depression, hostility, anxiety and other psychiatric symptoms, compared with before treatment was statistically significant (P <0.05), and no significant adverse reactions. Conclusion: Interferon-induced depression should be paid attention to, and early assessment, diagnosis and drug intervention are beneficial to improve patient compliance, safety and comprehensive efficacy.