氟西汀治疗脑卒中后抑郁临床研究

Clonical study of fluoxetine in poststroke depression

目的探讨氟西汀治疗脑卒中后抑郁的临床疗效和安全性。方法对64例脑卒中后抑郁患者在神经内科常规治疗的基础上口服氟西汀治疗,观察6w,于治疗前及治疗第1w、2w、4w、6w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应。结果汉密顿焦虑量表、汉密顿抑郁量表评分,入组患者治疗1w末起均较治疗前有显著下降(P<0.01),并随治疗时间的延续均呈持续性下降,各时点评分与上一时点评分比较均有极显著性差异(P均<0.01)。不良反应轻微,副反应量表评分在治疗全程无显著变化(P均>0.05)。结论氟西汀治疗脑卒中后抑郁疗效显著,不良反应较轻,依从性好,能显著改善脑卒中后抑郁患者的焦虑抑郁症状和认知功能、有利于患者神经功能的康复,提高生存质量,减少致残率。

Objective To explore the efficacy and safety of fluoxetine in poststroke depression. Methods 64 poststroke depression patients on neurological conventional therapy were added fluoxetine to for 6 weeks. Efficacies were assessed with the Hamilton Anxiety Scale（HAMA）and the Hamilton Depression Scale（HAMD） and adverse reactions with Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of the 1st,2nd,4th and 6th week. Results The HAMA and HAMD scores lowered more significantly since the end of the 1st week compared with pre-treatment（P〈0.01）and did contiously along with time of therapy lasting,there were significant differences among close timepoint score（all P〈0.01）. Adverse reactions were mild and the TESS scores had no significant changes during global therapy（all P〉 0.05）. Conclusion Fluoxetine has an evident effect,mild adverse reactions and better compliance,can improve anxious-depressive symptoms and cognitive function significantly,is in favor of neurofunctional rehabilitation,improve quality of life and reduce mutilation rate in poststroke depression.