长效干扰素治疗慢性乙型肝炎引发的精神心理异常及干预治疗效果分析

发布时间：2018-03-20 08:46

  本文选题：长效干扰素　切入点：慢性乙型肝炎　出处：《南方医科大学学报》2017年09期 　论文类型：期刊论文

【摘要】：目的分析长效干扰素(Peg IFN)治疗慢性乙型肝炎(CHB)引发的精神心理异常发生率,评估艾司西酞普兰和阿普唑仑干预对PegIFN所致抑郁和焦虑症状的疗效。方法 165例接受PegIFN治疗的CHB患者,治疗12周后,使用抑郁筛查量表(PHQ-9)和焦虑筛查量表(GAD-7)对其进行精神心理学评估;对筛选出的中重度抑郁和中重度焦虑的患者,采用艾司西酞普兰或阿普唑仑干预,分别于干预用药后第2、4、8周随访抑郁和焦虑症状的缓解程度,评估艾司西酞普兰和阿普唑仑分别对抑郁和焦虑的治疗效果。结果经量表检出并由精神科医师确认,37例为中重度抑郁,发生率为22.4%;31例为中重度焦虑,发生率为18.8%;其中,合并中重度抑郁和中重度焦虑的有17例,发生率为10.3%。艾司西酞普兰对抑郁和焦虑均有较好疗效(P=0.000),阿普唑仑对焦虑效果显著(P=0.001),但对抑郁效果不明显(P=0.904);在焦虑的改善方面,阿普唑仑比艾司西酞普兰疗效要好(t=-3.198,P=0.010)。结论 Peg IFN引发的抑郁和焦虑症状在我国CHB患者中发生率较高,应注意精神心理异常的评估;及时使用艾司西酞普兰或者阿普唑仑对Peg IFN引发的抑郁和焦虑症状有较好的疗效;同时可明显提高患者接受PegIFN治疗的依从性。
[Abstract]:Objective to analyze the incidence of psychosomatic abnormalities induced by long-term interferon peg IFN in the treatment of chronic hepatitis B (CHB). To evaluate the efficacy of escitalopram and alprazolam in the treatment of depression and anxiety caused by PegIFN. Methods 165 patients with CHB treated with PegIFN were treated for 12 weeks. The depression screening scale (PHQ-9) and anxiety screening scale (GAD-7) were used to evaluate the mental psychology, and the patients with moderate and severe depression and anxiety were treated with Escitalopram or alprazolam. The degree of remission of depression and anxiety were followed up at the 2nd week and 4th week after the intervention. Results 37 patients with moderate and severe depression and 31 patients with moderate and severe anxiety were diagnosed by the scale and confirmed by psychiatrists, and the incidence rate was 18.8. There were 17 patients with moderate and severe depression and moderate and severe anxiety, the incidence rate was 10.3.The alprazolam had a good effect on both depression and anxiety. Alprazolam had a significant effect on anxiety, but it had no significant effect on depression, and on the improvement of anxiety, alprazolam had a significant effect on anxiety, but the effect of alprazolam on depression was not obvious. Alprazolam was more effective than escitalopram. Conclusion the incidence of depression and anxiety caused by Peg IFN is higher in CHB patients in China. Timely use of Escitalopram or alprazolam has a good effect on depression and anxiety caused by PegIFN, and can significantly improve the compliance of patients with PegIFN.
【作者单位】： 南方医科大学南方医院感染内科;南方医科大学南方医院肝胆外科;南方医科大学中西医结合医院外二科;南方医科大学南方医院心理科;
【基金】：国家自然科学基金(81470856) 中国肝炎防治基金会课题(XJS20120601)~~
【分类号】：R512.62
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