摘要
目的:观察米氮平对脑梗死伴发抑郁患者的疗效及其对神经功能康复的影响。方法:选取经临床体格检查、神经影像学检查确诊为脑梗死,符合CCMD-2-R抑郁症诊断标准的患者117例,随机分为米氮平组57例和对照组60例。米氮平组除了服用米氮平外,其他治疗与对照组相同。分别在基线、治疗1周、3周、7周和6月时,进行汉密尔顿抑郁量表(HAMD)、Zung抑郁自评量表(SDS)、神经功能缺损量表(SSS)和日常生活能力量表(ADL)评定。结果:研究结束时,抗抑郁疗效,米氮平组57例(100%)全部达到有效,且痊愈41例(71·9%);对照组达到有效以上的共8例(13·4%),其中痊愈4例(6·7%)。神经功能康复,米氮平组显效率78·9%(45例),对照组显效率51·7%(31例)。从第3周起,米氮平组的日常生活能力就好于基线情况(31·2±11·2/39·2±15·8),到研究结束时,更是明显好于对照组(15·7±5·4/21·8±9·7,t=4·17,P<0·01)。结论:米氮平对脑梗死后抑郁具有很好的疗效,在抑郁症状改善的同时,促进患者神经功能和日常生活能力的恢复。
Objective： To observe the efficacy of mirtazapine in the treatment of depression after cerebral infarction and its effect on rehabilitation of neurological functions. Methods： 117 patients with acute cerebral infarction comorbid with major depression were randomly allocated to two groups treated with mirtazapine （57 cases ） or not （60 cases ）. Hamiltion Depression Rating Scale （ HAMD ）, Zung＇s Self-rating Depression Scale（ SDS）, modified Edingburgh- Scandinavian Stroke Scale （ SSS） and Activity of Daily Living（ ADL） were measured at baseline, 2 weeks, 4 weeks, 8 weeks and 6 months after randomization. Results： At the end of 6 months trial, the effective rate for depression of mirtazapine group was 100%, including 41 with relief （41/57, 71.9% ） ; while that of control group was 13.4% （3/ 60）, with only 4 with relief （6. 7% ）. For neurological function, 78.9% （45） patients in mirtazapine group had significant improvement, that number in control group was 31 （51.7% ）. From the third week, patients in mirtazapine group had better ADL results than baseline （ 31.2 ± 11.2/39. 2 ± 15.8 ）, at the end of 6 months, their activity of daily life was much better than that of control （ 15.7 ±5.4/21.8 ±9.7, t =4. 17 ,P 〈0. 01 ）. Conclusion： Mirtazapine is effective in the treatment of depression after cerebral infarction, and it can improve the ability of daily living and neurological function.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2006年第7期486-487,489,共3页
Chinese Mental Health Journal
关键词
脑梗死
抑郁
米氮平
神经功能
康复
cerebral infarction
depression
mirtazapine
neurological function
rehabilitation
