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目的：探讨西酞普兰与氯米帕明对首发抑郁症患者临床疗效和安全性以及血清、脑脊液唾液酸水平的影响。方法将126例首发抑郁症患者按就诊顺序分成两组，每组63例，分别口服西酞普兰和氯米帕明治疗，观察8周。治疗前后采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应，同时检测血清、脑脊液唾液酸水平的变化。结果治疗后两组汉密顿抑郁量表评分均较治疗前显著下降（P＜0．01），西酞普兰组治疗第1周、2周末较氯米帕明组下降更显著（ P＜0．01），治疗8周末西酞普兰组总有效率为82．5％，氯米帕明组为74．6％，两组比较差异无显著性（P＞0．05）。两组不良反应较轻微，但两组便秘、睡眠障碍发生率比较差异有显著性（P＜0．05）。治疗前两组血清、脑脊液唾液酸水平均高于正常值，治疗后两组血清、脑脊液唾液酸水平均较治疗前呈持续性下降（P＜0．01），西酞普兰组治疗第4周末均显著低于氯米帕明组（P＜0．01），两组其他时点检测结果比较差异均无显著性（P＞0．05）。结论西酞普兰与氯米帕明治疗首发抑郁症疗效显著且相当，但西酞普兰起效更快，不良反应较少；首发抑郁症患者发病期间血清、脑脊液唾液酸水平均明显升高，经抗抑郁药物治疗后随着抑郁症状的改善，血清、脑脊液唾液酸水平也逐渐降低。“,”Objective To explore influences of citalopram and clomipramine on the curative effect and sialic acid in serum and cerebrospinal fluid of first‐episode depression patients .Methods A total of 126 patients with first‐episode depression were randomly divided into two groups of 63 one each according to visiting or‐der ,took orally citalopram or clomipramine for 8 weeks .Curative effects were assessed with the Hamilton Depression Scale (HAMD) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) ,at the same time sialic acid changes in serum and cerebrospinal fluid detected . Results After treatment the HAMD scores of both groups lowered more significantly compared with pre‐treatment (P<0 .01) ,so did those at the ends of the 1st and 2nd week in citalopram than in clomipramine group (P0 .05) .Pre‐treatment sialic acid levels in both serum and cerebrospinal fluid were higher than norm value ,after treatment sialic acid levels in both serum and cerebrospinal fluid continuously lowered compared with pretreatment (P<0 .01) ,those were significantly lower at the end of the 4th week in citalopram than clomipramine group (P0 .05) .Con‐clusion Citalopram and clomipramine have equivalent and evident effects in the treatment of first‐episode depression ,but the former takes effects more rapidly and has few adverse reactions ;sialic acid levels in both serum and cerebrospinal fluid of first‐episode depression patients heightened notably during onset pe‐riod and lower gradually along with the improvement of depressive symptoms through antidepressant treat‐ment .