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目的探讨米氮平对伴2型糖尿病抑郁障碍患者血脂代谢的影响。方法将90例伴糖尿病的中度抑郁障碍患者随机分为3组(各30例):米氮平(30~45 mg·d~(-1))组、舍曲林(125~200 mg·d~(-1))组、心理治疗(每周进行1~2次认知治疗)组,治疗时间均为12周。3组患者均于治疗前测定空腹血糖;另于治疗前及治疗第4、8、12周末分别测定血清总胆固醇及血清三酰甘油,比较测定值的变化。结果米氮平组、舍曲林组及心理治疗组分别脱落3例、1例及4例。在整个治疗期间,米氮平组与舍曲林组或心理治疗组比较,总胆固醇均有显著差异(P=0.030,P=0.016),而后两组间无显著差异(P=1.000);3组间相互比较,三酰甘油均无显著差异(均P>0.05)。12周末时,3组间血清总胆固醇升高率有显著差异(χ~2=7.253,P=0.027),且其总体频率的95%置信区间为0~3.0%,米氮平组的升高率最高,且该组的升高率随治疗时点延长逐渐升高;米氮平组内第4、8、12周末分别与基线比较,三酰甘油均无显著差异(均P>0.05)。结论米氮平治疗伴2型糖尿病的中度抑郁障碍患者可导致总胆固醇水平升高,且其升高率随治疗时间的延长而逐渐增加;米氮平对该类患者的三酰甘油水平无明显影响。
Objective To investigate the effect of mirtazapine on blood lipid metabolism in patients with type 2 diabetes mellitus. Methods 90 patients with moderate depression with diabetes mellitus were randomly divided into 3 groups (30 in each group): mirtazapine (30 ~ 45 mg · d -1), sertraline (125 ~ 200 mg · d -1) d ~ (-1)) group, psychological treatment (once or twice a week cognitive therapy) group, the treatment time was 12 weeks. The fasting blood glucose was measured in all three groups before treatment. The other two groups were measured serum total cholesterol and serum triglyceride before treatment and at the end of the 4th, 8th and 12th week of treatment respectively. Results Mirtazapine, sertraline group and psychological treatment group were shedding in 3 cases, 1 case and 4 cases. There was a significant difference in total cholesterol between the mirtazapine group and the sertraline group or the psychotherapy group during the entire treatment period (P = 0.030, P = 0.016), with no significant difference between the latter two groups (P = 1.000); 3 There was no significant difference in triglyceride between groups (P> 0.05). At the end of 12th week, there was a significant difference in the rate of increase of total cholesterol (χ ~ 2 = 7.253, P = 0.027) between the three groups, and the 95% confidence interval of the overall frequency was 0-3.0% The highest rate, and the rate of increase in this group increased gradually with the time point of treatment. In the mirtazapine group at the 4th, 8th, and 12th week respectively, there were no significant differences in triglyceride between the two groups (all P> 0.05). Conclusion Mirtazapine in patients with moderate dementia associated with type 2 diabetes can lead to elevated total cholesterol levels, and the rate of increase with the extension of treatment time gradually increased; mirtazapine in patients with triglyceride levels were no Clearly affected.