氟西汀对脑卒中患者抑郁状况及生活质量的影响

Effect of fluoxetine on the depressive status and quality of life in patients with stroke

目的:脑卒中后抑郁发病率高,且严重影响脑卒中患者的生活质量,研究氟西汀对其情感障碍及生活质量的改善作用,为临床提供参考依据。方法:研究对象为1999-03/2002-07在同济医院神经内科和荆州市第一人民医院神经内科住院的脑卒中患者,共112例。随机分为治疗组和对照组,治疗组给予口服氟西汀,并给予改善脑部血液供应、营养神经细胞及常规康复治疗;对照组给予心理治疗,其余治疗同治疗组。采用汉密顿抑郁量表、日常生活活动能力及生活质量指数量表评分,观察患者治疗前后抑郁状态、日常生活活动能力及生活质量的变化情况。结果:治疗组、对照组总有效率分别为80.9%,61.2%,两组相比差异具有显著性意义(χ2=5.36,P<0.05)。治疗组治疗后汉密顿抑郁量表,日常生活活动能力,生活质量指数评分较治疗前明显改善(t=8.4,7.6,2.8,P<0.05);治疗后治疗组汉密顿抑郁量表、日常活动能力.生活质量指数评分较对照组增高(t=5.2,5.9,6.6,P<0.05)。结论:氟西汀对脑卒中后抑郁状态,日常生活活动能力均有显著改善作用,可促进脑卒中患者的神经功能恢复,提高其生活质量。

AIM: The incidence rate of depression is high after cerebral apoplexy, and it severely influences the quality of life(QOL) of the patients. This paper aims to investigate the effect of fluoxetine in ameliorating their mood disorder and QOL, so as to provide clinical references.METHODS:Totally 112 inpatients after cerebral apoplexy, who were hospitalized in the Department of Neurology, Tongji Hospital and Jingzhou First People's Hospital from March 1999 to July 2002, were randomly divided to treatment group and control group.All the patients received treatment for improving the cerebral blood supply, nourishing nerve cell and routine rehabilitative interventions, besides patients in the treatment group were treated with oral fluoxetine, while psychotherapy was given to those in the control group. Patients in both groups were investigated with the Hamliton depression scale (HAMD), activities of daily life (ADL) and quality of life index (QL Index) scales, the changes of depressive status, ADL and QOL of the patients before and after treatment were observed. RESULTS: There was significant difference in the total effective rate between the treatment group(80.9%) and control group(61.2%) (χ2=5.36, P< 0.05). In the treatment group, the scores of HAMD, ADL and QL Index after treatment were all obviously improved as compared with those before treatment (t=8.4, 7.6, 2.8, P< 0.05) and those in the control group (t=5.2, 5.9, 6.6, P< 0.05).CONCLUSION: Fluoxetine can significantly ameliorate the depressive state and ADL after cerebral apoplexy, it can also promote the recovery of neurological function and improve the QOL of patients after cerebral apoplexy.