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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。
Objective To analyze the incidence of psychiatric disorders induced by Peg IFN in patients with chronic hepatitis B (CHB) and evaluate the efficacy of escitalopram and alprazolam in the treatment of depression and anxiety symptoms caused by PegIFN. Methods A total of 165 CHB patients treated with PegIFN were enrolled in this study. After 12 weeks of treatment, they were assessed psychologically with Depression Screening Scale (PHQ-9) and Anxiety Screening Scale (GAD-7) Severe depression and moderate to severe anxiety patients, the use of escitalopram or alprazolam intervention, respectively, at the 2nd, 4th, and 8th weeks after the intervention were followed up to assess the extent of depression and anxiety symptoms, assessment of escitalopram and Alprazolam, respectively, on the treatment of depression and anxiety. The results were confirmed by the psychiatrist, 37 cases were moderate-severe depression, the incidence was 22.4%; 31 cases were moderate-severe anxiety, the incidence was 18.8%; Among them, the combination of moderate and severe depression and moderate to severe anxiety There are 17 cases, the incidence was 10.3%. Escitalopram had good effect on both depression and anxiety (P = 0.000), alprazolam had significant effect on anxiety (P = 0.001), but had no effect on depression (P = 0.904) Alprazolam was more effective than escitalopram (t = -3.198, P = 0.010). Conclusions The incidence of depression and anxiety caused by Peg IFN is higher in patients with CHB in our country. Pay attention to the assessment of mental and psychiatric abnormalities. Timely use of escitalopram or alprazolam for Peg IFN-induced depression and anxiety symptoms Good effect; at the same time can significantly improve the compliance of patients receiving PegIFN treatment.