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目的观察氟哌噻吨美利曲辛片对老年胶质瘤术后睡眠障碍患者血清5-羟色胺(5-HT)、抑郁自评量表(SDS)及甲状腺激素水平的影响。方法86例老年胶质瘤术后伴有睡眠障碍患者分为对照组43例与试验组43例。试验组口服氟哌噻吨美利曲辛10.5 mg,每日1次;对照组口服艾司唑仑1~2 mg,每日1次,2组疗程均为4周。比较2组患者治疗前后血清5-HT、匹兹堡睡眠质量指数量表(PSQI)、SDS评分及甲状腺激素水平。结果试验组的总有效率为93.02%(40/43例),对照组的总有效率为76.74%(33/43例,P<0.05)。治疗后,试验组PSQI为(8.04±1.12)分,对照组为(11.74±1.32)分;试验组SDS为(37.62±5.60)分,对照组为(46.82±6.23)分;试验组促甲状腺素(TSH)为(6.23±0.62)m U·L~(-1),对照组为(7.16±0.78)m U·L~(-1);试验组游离三碘原氨酸(FT3)为(6.62±0.89)pmol·L~(-1),对照组为(7.43±1.06)pmol·L~(-1);试验组游离甲状腺素(FT4)为(15.63±2.61)pmol·L~(-1),对照组为(18.92±3.57)pmol·L~(-1),2组差异有统计学意义(P<0.05)。治疗后,试验组5-HT为(109.37±11.26)μmol·L~(-1),对照组为(154.05±17.49)μmol·L~(-1)(P<0.05)。药物不良反应主要表现为头痛、口干,试验组药物不良反应发生率为6.98%(3/43例),对照组药物不良反应发生率为2.33%(1/43例),差异无统计学意义(P>0.05)。结论氟哌噻吨美利曲辛能明显改善老年胶质瘤术后睡眠障碍患者的睡眠质量,降低抑郁程度,安全性高。
Objective To observe the effects of flupenthixol and melitracen on serum 5-HT, SDS and thyroid hormone in patients with sleep disorders after geriatric glioma. Methods 86 cases of elderly patients with glioma postoperative sleep disorders were divided into control group 43 cases and test group 43 cases. The test group oral flupenthixol mometasone 10.5 mg, 1 day; control group oral administration of estazolam 1 ~ 2 mg, 1 day, 2 courses were 4 weeks. Serum 5-HT, Pittsburgh Sleep Quality Index (PSQI), SDS score and thyroid hormone levels were compared between the two groups before and after treatment. Results The total effective rate was 93.02% (40/43 cases) in the experimental group and 76.74% (33/43 cases, P <0.05) in the control group. After treatment, PSQI was (8.04 ± 1.12) in the test group and (11.74 ± 1.32) in the control group; SDS was (37.62 ± 5.60) in the test group and (46.82 ± 6.23) in the control group. The levels of thyrotropin TSH was (6.23 ± 0.62) m U · L -1 in the control group and (7.16 ± 0.78) m U · L -1 in the control group. Free triiodothyronine (FT3) in the test group was ( 6.62 ± 0.89) pmol·L -1 in the control group and (7.43 ± 1.06) pmol·L -1 in the control group. The free thyroxine (FT 4) in the test group was (15.63 ± 2.61) pmol·L -1 1), and the control group was (18.92 ± 3.57) pmol·L -1. The difference between the two groups was statistically significant (P <0.05). After treatment, the 5-HT level in the experimental group was (109.37 ± 11.26) μmol·L -1 and that in the control group was (154.05 ± 17.49) μmol·L -1 (P <0.05). Adverse drug reactions mainly manifested as headache, dry mouth, the incidence of adverse drug reactions in the experimental group was 6.98% (3/43 cases), the incidence of adverse drug reactions in the control group was 2.33% (1/43 cases), the difference was not statistically significant (P> 0.05). Conclusion Flupentixol and melitracen can significantly improve the quality of sleep, reduce the degree of depression and improve the safety of patients with postoperative sleep disorders in elderly gliomas.