中文摘要：

目的评价草酸艾司西酞普兰联合奥氮平治疗老年抑郁症的临床疗效及安全性。方法入选2012年2月至2014年4月我科收治的老年抑郁症患者62例为研究对象,随机分为奥氮平联合草酸艾司西酞普兰治疗组（试验组,n=29）和草酸艾司西酞普兰组（对照组,n=33）。对照组给予草酸艾司西酞普兰10mg·d-1口服,疗程8周;试验组在对照组的基础上,加用奥氮平起始剂量2.5mg·d-1,1周内可加至5~10 mg·d-1,疗程8周。2组患者分别在治疗前及治疗后1,2,4,6,8周末时,用汉密尔顿抑郁量表（HAMD）及相关不良反应量表（TESS）评估2组患者临床疗效及不良反应。结果治疗2周末至8周末,2组患者HAMD评分较治疗前均显著降低（均P〈0.05）;治疗4周末至8周,试验组HAMD评分较对照组显著降低（均P〈0.05）。8周末时,试验组10%以上患者体重增加显著高于对照组（P〈0.05）;而其他不良反应（如头晕、口干、便秘、恶心等）的发生率比较,差异无统计学意义（均P〉0.05）。结论奥氮平联合草酸艾司西酞普兰治疗老年抑郁症起效快,临床疗效较单用草酸艾司西酞普兰好,但可显著增加患者体重。

英文摘要：

Objective To assess the clinical efficacy and adverse reac-tions of olanzapine combined with escitalopram oxalate on depressive disorder in elderly patients.Methods Sixty two elderly patients with depressive disorder were recruited from February 2012 to April 2014 in our hospital and were randomized divided into the control group （ n=33 ） and experiment group （ n=29 ）.Patients in the control group were given escitalopram oxalate 10 mg · d-1 orally for 8 weeks and patients in the experiment group were given escitalopram oxalate 10 mg · d-1 combined olanzapine 2.5 mg· d-1 （ initially） ,ranging from 5 to 10 mg· d-1 within the first week.The data of hamilton depression scale （ HAMD） and treat-ment emergent symptom scale （ TESS ） score were recorded between the two groups to evaluate the clinical efficacy and adverse reactions before treatment and 1, 2, 4, 6 and 8 weeks after treatment.Results From the end of the second week to the eighth week , the HAMD scale were significantly decreased in both groups （ P 〈0.05 ）.At the end of the fourth week to the eighth week , the HAMD score in the experiment group were significantly lower than those in control group （ P 〈0.05 ）.After＆amp;nbsp;8 weeks, more than 10%patients in the experiment group showed weight gain , higher than those in the control group （P〈0.05）.The other adverse reactions such as dizziness , dry mouth, constipation and nausea showed no statistical differences（ P〉0.05 ）.Conclusion Olanzapine combined with escitalopram oxalate in the treatment of depressive disorder in elderly patients can rapidly improve the symptom and have better clinical efficacy , but the weight gain was a common adverse reaction.