| Objective:To explore the effects of different anti-depressant drugs on serum S100 B protein(S100B)and serum brain-derived neurotrophic factor(BDNF)and cognitive function in patients with depression.Methods:120 patients with depression were divided into observation group(agomelatine group)and control group(venlafaxine group)by random number table method,with 60 patients in each group.The observation group was treated with agomelatine 25-50 mg per day and the control group with venlafaxine 225 mg per day.The observation group was treated with agomelatine servier(manufacturer: Les Laboratoires Servier,specification: 25 mg,approval no.: H20120303)with a starting dose of 25mg/d,which gradually increased to 50mg/d within 1w according to the patient’s condition.Control group applied venlafaxine sustained-release capsule(manufacturer: Pfizer Healthcare Ireland,specification: 75 mg,150mg approval number: J20120038)treatment,initial dose of 75mg/d,gradually increased to 150 ~ 225mg/d in 1 week according to the patient’s condition.Two groups have been 6 weeks treatment,compared two groups before treatment and after treatment 6 w depression symptom severity,with Hamilton depression scale(HAMD)and BECK depression questionnaire,comparative observation group and control group 2 points rate of depression scale for assessment of cognitive function in Mr Waxman le memory scale fourth edition of Chinese version(an adult)auditory memory,visual memory,visual working memory,immediate memory and delayed memory score each project assess patients with memory function,Wsiconsin card sorting test(WCST)was used to evaluate the executive function of patients,including total number of responses,correct number of responses,persistent number of errors,random number of errors,and complete classification number score.The differences in serum S100 B and BDNF levels of patients with depression before and after treatment were compared,and the incidence rate of adverse reactions was recorded in the two groups.Peripheral venous blood was extracted before and after 6 weeks of treatment,and serum S100 B protein(S100B)and brain-derived neurotrophic factor(BDNF)levels were measured by ELISA.SPSS19.0 software was used for statistical analysis of the original data.The measurement data were represented by (?)±S,and t test was used for comparison between groups.The chi-square test was used for intra-group comparison.Logistic regression was used to analyze the correlation,and P<0.05 was considered statistically significant.Results:1.After 6 weeks of treatment,the severity of symptoms(HAMD and BECK scores)of the agomelatine group and the venlafaxine group were significantly lower than before treatment(P<0.05).The score reduction rate between the two groups was not significantly different(P>0.05),and the overall effect was similar.2.S100 B protein and BDNF levels were compared before and 6 weeks after treatment in the 2 groups,and S100 B protein levels were lower in the 2 groups than before treatment(P<0.05),and BDNF level was significantly higher in the 2 groups than before treatment(P<0.05).3,Cognitive function comparison: after WCST measurement of executive function,executive function in patients with 2 group were improved to varying degrees,argonaut Melanesia Christian groups in the total number of responses,the number of correct responses,the last count,the number of random errors,the complete classification error scores are slightly higher than the venlafaxine group of patients,but the two groups of indicators to improve obvious value difference,P < 0.05,with statistical significance.After 6 weeks of treatment,the memory function of the two groups was compared,and the scores of auditory memory,visual memory,visual working memory,immediate memory and delayed memory were significantly higher than those before treatment after the wexler memory scale iv Chinese version(adult version).The two groups were superior to the venlafaxine group in terms of the value of memory function improvement,and the data of the two groups were statistically different.4.Comparison of the incidence of adverse reactions: there were 3 cases(5%,3/60)of adverse reactions in the agomelatine group,and the adverse reactions were minor;9 cases(15%,9/60)of adverse reactions in the venlafaxine group.The adverse reactions were relatively serious,and the overall differences between the two groups were more obvious in side effects(P<0.05).5.The results of binary Logistic regression analysis showed that the increase of serum BDNF after treatment was correlated with the improvement of cognitive function(ratio: 3.251,95% confidence interval: 1.237-8.635,P=0.030).The decrease of serum S100 B protein concentration was correlated with the improvement of cognitive function.(ratio: 2.178,95% confidence interval: 1.038-6.851,P=0.020).Conclusions:1.The treatment effect of agomelatine on patients with depression is roughly equivalent to that of the venlafaxine group.The agomelatine group reflects that the drug has great therapeutic advantage on some symptom items,such as improving sleep,improving daytime alertness and subjective well-being,but the overall effect is equal.2.After 8W of treatment,serum S100 B protein value in both groups was significantly lower than that before treatment,and BDNF value was significantly higher than that before treatment,which was significantly correlated with HAMD and BECK depression scale values,indicating that S100 B protein concentration was positively correlated with the severity of depressive symptoms,and BDNF was positively correlated with the improvement of depressive symptoms.It also shows that agomelatin and venlafaxine also play a certain role in the repair of neuron injury in patients with depression.There was a correlation between the increase of serum BDNF concentration and the decrease of S100 B protein concentration and the improvement of cognitive function after drug treatment.3.In terms of improving the cognitive function of patients: the improvement effect of the regalamine group on the cognitive function of patients was similar to that of the venlafaxine group.The serum S100 B protein and BDNF values of patients in group 2 were significantly changed after treatment for 8W,and the values were significantly correlated.In terms of the improvement degree of various numerical values,the agomelatine group was significantly superior to the venlafaxine group.The data difference between the two groups was statistically significant,indicating that the agomelatine was superior to venlafaxine in terms of the improvement of executive function and memory learning ability. |
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