摘要
目的探讨抗抑郁药物早期干预对卒中后急性期抑郁状态及神经功能康复的影响。方法临床纳入卒中后急性期抑郁状态患者96例,根据随机数字表法将患者分为研究组与对照组,每组各为48例,研究组给予口服抗抑郁药物(西酞普兰)治疗,对照组仅给予空白安慰剂治疗。治疗前与治疗8后周采用汉密顿抑郁量表(Hamilton Depression Scale,HAMD)对患者的抑郁症状进行评估,美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)对患者的神经功能进行评估,采用Barthel指数(BI)对患者的日常生活活动能力(ADL)进行评估。此外,分别检测治疗前后患者的血浆P物质(SP)以及神经肽Y(NPY)水平。结果治疗后,研究组HAMD、NIHSS、ADL评分分别为(13.6±2.9)、(10.5±3.3)、(79.2±13.5),对照组HAMD、NIHSS、ADL评分分别为(23.7±5.2)、(16.3±4.0)、(57.2±8.9),差异均有显著性(P<0.05);治疗后研究组血浆SP水平为(35.6±12.2),明显低于对照组的(53.1±16.8),差异有显著性(P<0.05);治疗后研究组血浆NPY水平为(165.9±44.0),明显高于对照组的(129.3±28.5),差异有显著性(P<0.05)。结论卒中后急性期抑郁患者给予西酞普兰进行药物干预,能够有效改善卒中后急性期抑郁状态,缓解患者的负面情绪。而血浆SP水平降低,NPY水平升高,可能是西酞普兰起到抗抑郁作用的机制。
Objective To investigate the effect of early antidepressant intervention on the acute depression and rehabilitation of neurological function after stroke. Methods 96 acute depression patients after stroke were selected and randomly divided into study group and control group. 48 cases each group. The study group orally took the antidepressant（ citalopram）; the control group took placebo. Before and after 8w of treatment,the patient＇s depression was evaluated by HAMD and the neurological function was evaluated by NIHSS; the patient＇s ADL was evaluated by BI. In addition,the level of SP and NPY was detected before and after treatment. Results After treatment,HAMD,NIHSS and ADL scores of study group were（ 13. 6 ± 2. 9） and（ 10. 5 ± 3. 3） and（ 79. 2 ±13. 5） while HAMD,NIHSS and ADL scores of control group were（ 23. 7 ± 5. 2） and（ 16. 3 ± 4） and（ 57. 2 ＋8. 9）（ P〈0. 05）; After treatment,SP level of study group（ 35. 6 ± 12. 2） was significantly lower than that of control group（ 53. 1 ± 16. 8）（ P〈0. 05）; after treatment,NPY level of study group（ 165. 9 ± 44） was significantly higher than that of control group（ 129. 3 ± 28. 5）（ P〈0. 05）. Conclusion For acute depression patients after stroke,the drug intervention of citalopram can effectively improve the acute depression after stroke and alleviate the patients＇ negative mood. In addition,the reducing SP level and rising NPY may be its antidepressant mechanism.
出处
《国际精神病学杂志》
2015年第5期97-100,共4页
Journal Of International Psychiatry
关键词
抗抑郁药物
卒中
急性期抑郁状态
神经功能康复
影响
Antidepressant Drugs
Stroke
Acute Depression
Rehabilitation OF Neurological Function
Effect
