脑卒中后抑郁早期干预对运动功能恢复和再发脑卒中的影响

Effect of early intervention on recovery of motor function and recurrent stroke in patients with post-stroke depression

目的:探讨脑卒中后抑郁的早期干预对发病后3个月时的运动功能及3年内再发性脑卒中发生率的影响。方法:将2000-01/2004-08南阳市中心医院收治180例诊断为脑卒中后抑郁的患者随机分为治疗组90例和对照组90例,两组的神经功能缺损程度无统计学差异(P>0.05)两组的基础治疗相同,疗程1个月。而治疗组在确诊为脑卒中后抑郁的同时给予抗抑郁治疗:氟西汀20mg/d,连续服用3个月。结束后两组用脑卒中患者临床神经功能缺损程度评分标准评定患者的病情严重程度;用汉密顿抑郁量表评定抑郁程度。结果:治疗组治疗后汉密顿抑郁量表评分为6.4±6.2,治疗前为18.5±6.0;差异有非常显著性意义(P<0.01);治疗后神经功能缺损程度评分:治疗组为10.4±8.5;对照组为22.6±8.9,差异有显著性意义(P<0.05);3年内再发性脑卒中的发生率治疗组为7%,对照组为31%,差异有显著性意义(P<0.05)。结论:脑卒中后抑郁的早期干预可降低神经功能缺损的积分,减少3年内再发性脑卒中的发生率。

AIM: To probe into the effect of early intervention for post stroke depression (PSD) on movement function after three months of stroke and the incidence rate of recurrent stroke within three years.METHODS: Totally 180 patients hospitalized in Nanyang Central Hospital from January 2000 to August 2004, who were diagnosed as having PSD, were divided at random into a treatment group (90 cases) and a control group (90 cases).In the severity of neurological function damage, there was no statistical difference between the two groups (P >0.05),which were given similar treatments of one month. At the same time when diagnosed as having PSD, the treatment group was given an anti depression treatment: fluoxetine 20 mg once a day, continuously for three months.After that, evaluation severity of clinic extent of neurological function damage was used to assess the severity of patients' disease; and Hamilton rating scale for depression(HAMD) was taken to evaluate the severity of depression.RESULTS:HAMD score of treatment group was 6.4±6.2 after treatment,and 18.5±6.0 before treatment,and there was significant difference(P< 0.01).The score on the extent of neurological function damage was 10.4±8.5 in the treatment group,and 22.6±8.9 in the control group,and there was significant difference(P< 0.05).The incidence rate of recurrent stroke within three years in the treatment group was 7.1%,and 31%in the control group, and there was significant difference (P < 0.05).CONCLUSION: Early intervention in post stroke depression can lower the scores of neurological function defect and the incidence rate of recurrent stroke in three years,and reduce death rate.