目的 探究草酸艾司西酞普兰联合喹硫平治疗双相情感障碍（BPD）抑郁发作的临床疗效。方法 选取2020年5月—2022年5月新疆维吾尔自治区人民医院收治的104例BPD抑郁发作患者，随机数字表法将患者以1∶1比例分为对照组和治疗组，每组各52例。对照组患者口服富马酸喹硫平片，初始剂量50 mg/次，2次/d；每日增加50～100 mg，直至300～600 mg/d。治疗组在对照组基础上口服草酸艾司西酞普兰片，初始剂量10 mg/次，1次/d，服用1周后根据情况剂量调整为20 mg/次，1次/d。两组患者均治疗8周。观察两组患者临床疗效，比较治疗前后两组患者汉密尔顿抑郁量表（HAMD）评分和杨氏躁狂量表（YMRS）评分，血清白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、巨噬细胞移动抑制因子（MIF）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）、丙二醛（MDA）和谷胱甘肽过氧化物酶（GSH-Px）水平。结果 治疗后，治疗组总有效率为88.46%，较对照组的71.15%明显升高（P＜0.05）。治疗后，两组患者HAMD评分均较治疗前降低（P＜0.05），且治疗组较对照组降低更显著（P＜0.05）。治疗后，两组患者血清IL-6、IL-1β、MIF和MDA水平均较治疗前明显降低，而血清SOD、CAT、GSH-Px水平均较治疗前明显升高（P＜0.05），且治疗组血清学指标改善水平明显好于对照组（P＜0.05）。结论 草酸艾司西酞普兰联合喹硫平治疗BPD抑郁发作患者效果显著，可有效改善抑郁症状，抑制机体炎症，调节氧化应激状态，不增加转躁风险。

Objective To investigate the clinical efficacy of escitalopram oxalate combined with quetiapine in treatment of depressive episode of bipolar disorder. Methods A total of 104 patients with BPD depressive episode admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from May 2020 to May 2022 were selected. The patients were divided into control group and treatment group with a ratio of 1:1 by random number table method, with 52 cases in each group. Patients in the control group were po administered with Quetiapine Fumarate Tablets, the initial dose was 50 mg/time, twice daily, and the daily increase was 50 — 100 mg until 300 — 600 mg/d. Patients in the treatment group were po administered with Escitalopram Oxalate Tablets on the basis of the control group, the initial dose was 10 mg/time, once daily, and after a week, the dose was adjusted to 20 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluation was evaluated, and the scores of HAMD and YMRS, the levels of serum IL-6, IL-1β, MIF, SOD, CAT, GSH-Pxand MDA in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 88.46%, which was significantly higher than that of the control group (71.15%, P < 0.05). After treatment, the HAMD scores of patients in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of serum IL-6, IL-1β, MIF and MDA in two groups were significantly lower than those before treatment (P < 0.05), while the levels of serum SOD, CAT and GSH-Px were significantly higher than those before treatment (P < 0.05), and the improvement level of serological indexes in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Escitalopram oxalate combined with quetiapine is effective in treatment of depressive episode of bipolar disorder. It can effectively improve depressive symptoms, inhibit inflammation, regulate oxidative stress, and does not increase the risk of becoming irritable.

R971

新疆维吾尔自治区自然科学基金资助项目（2021D01C157）