艾司西酞普兰联合舍曲林对性伴焦虑症状的产后抑郁症的疗效及对性激素水平的影响

Efficacy of escitalopram combined with sertraline on postpartum depression with anxiety symptoms and its influence on sex hormones levels

摘要:

目的 观察艾司西酞普兰（ES）联合舍曲林（SER）对性伴焦虑症状的产后抑郁症（PDD）的疗效及对性激素水平的影响。方法 选取2021年2月至2022年12月宜春市妇幼保健院收治的68例伴焦虑症状的PDD患者，按照随机数字表法分为SER组（n=34，采用SER治疗）和ES+SER组（n=34，采用ES联合SER治疗）。比较两组患者治疗前后焦虑抑郁程度〔汉密顿焦虑、抑郁量表（HAMA、HAMD）评分〕、血清学指标〔白细胞介素（IL）-6、IL-1β、肿瘤坏死因子-α（TNF-α）〕、性激素水平〔雌二醇（E2）、孕酮（P）、催乳素（PRL）〕、不良反应。结果 治疗后，两组HAMA、HAMD评分均下降（P＜0.05），且治疗后ES+SER组低于SER组（P＜0.05）。治疗后，两组IL-6、IL-1β、TNF-α水平均下降（P＜0.05），且治疗后ES+SER组低于SER组（P＜0.05）。治疗后，ES+SER组E2、PRL水平均升高（P＜0.05），P水平下降（P＜0.05），且治疗后组间比较差异均有统计学意义（P＜0.05）。两组不良反应发生率的差异无统计学意义（P＞0.05）。结论 ES联合SER可有效改善伴焦虑症状的PDD的负性情绪，促使炎性因子下降，调节性激素水平，同时兼具良好的安全性。

Abstract:

Objective To observe the efficacy of escitalopram (ES) combined with sertraline (SER) on postpartum depression (PDD) with anxiety symptoms and its influence on sex hormones levels.Methods Sixty-eight PDD patients with anxiety symptoms in Yichun Maternal and Child Health Hospital were selected from February 2021 to December 2022, and were divided into SER group (n=34, treated with SER) and ES+SER group (n=34, treated with ES combined with SER) according to the random number table method. The anxiety degree and depression degree 〔Hamilton Anxiety and Depression Scales (HAMA, HAMD) scores〕, serological indicators 〔interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α)〕 and sex hormones 〔estradiol (E2), progesterone (P), prolactin (PRL)〕 before and after treatment and adverse reactions were compared between groups.Results After treatment, the HAMA score and HAMD score in both groups were decreased (P＜0.05), and the scores in ES+SER group after treatment were lower than those in SER group (P＜0.05). The levels of IL-6, IL-1β and TNF-α were declined in the two groups after treatment (P＜0.05), and the above levels after treatment were lower in ES+SER group than those in SER group (P＜0.05). After treatment, the levels of E2 and PRL in ES+SER group were enhanced (P＜0.05), while the level of P was reduced (P＜0.05), and there were statistical differences between groups after treatment (P＜0.05). The incidence rates of adverse reactions revealed no statistical differences between the two groups (P＞0.05).Conclusion ES combined with SER can effectively improve the negative emotions of PDD with anxiety symptoms, promote the decreases of inflammatory factors, regulate the levels of sex hormones, and it has good safety.