抗抑郁剂治疗脑卒中后抑郁障碍

Controlled Trial for Treating Depressive Disorder Following Cerebral Infarction

目的:探讨抗抑郁剂的应用对脑卒中后抑郁障碍患者的影响。方法:汉密顿抑郁量表(HAMD)总分≥1 4的脑卒中患者7 2例,随机分为3组各2 4例,在按脑卒中常规治疗基础上,A组给予1 0-3 0 mg/d帕罗西汀治疗,B组5 0-1 5 0 mg/d阿米替林治疗,C组为空白对照。治疗6及1 2周后采用HAMD、神经功能缺损评分及副反应量表(TESS)评定。结果:与治疗前及C组比较,A、B组治疗6及1 2周后HAMD总分及神经功能缺损评分均显著下降(P<0.0 5),A组优于B组(P<0.0 5);TESS总分,A组明显低于B组(P<0.0 0 1)。结论:帕罗西汀及阿米替林能显著改善脑卒中后合并抑郁障碍患者的抑郁症状及神经功能,且帕罗西汀对神经功能的恢复及减少药物副作用等方面优于阿米替林。

Objective: To study the action of antidepressant for depressive disorder following cerebral infarction.Methods: Among 72 patients with cerebral infarction and depressive disorder,24 patients were treated with paroxetine(10-30 mg/d),24 with amitriptyline(50-150 mg/d),and 24 served as blank control group.HAMD and Neurological Functional Deficit Scales were performed 6 and 12 weeks after treatment.Results: The HAMD scores in paroxetine group and amitriptyline group were significantly decreased 6 and 12 weeks after treatment,as compared with those in blank control group.Neurological Functional Deficit Scales in the paroxetine group were significantly lower than in blank control group 12 weeks after treatments.The patients treated with paroxetine had less side effects.Conclusion: Paroxetine and amitriptyline could improve Neurological Functional Deficit Scales and depressive disorder following cerebral infarction.Paroxetine is better than amitriptyline in terms of Neurological Functional Deficit Scales and side effects.