老年性缺血性脑卒中后抑郁干预治疗对神经功能恢复的疗效分析

Influence of antidepressant treatment on the recovery of neurological function in elderly patients with ischemic stroke

目的:对老年性缺血性脑卒中后抑郁(post stroke depression,PSD)患者进行抑郁干预治疗,探讨抑郁干预治疗治疗对神经功能恢复的疗效。方法:对入选的40例老年性缺血性脑卒中抑郁患者分为观察组和对照组,两组各20例,于治疗前、治疗后10周各采用神经功能缺损量表(DNF)评定和汉密尔顿抑郁量表(HAMD)评定1次,于治疗2、10周末各采用副反应量表(TESS)评定副作用1次,进行疗效及副作用评定。结果:与对照组相比,观察组DNF和HAMD评分的减分率均较高(P<0.05)。相关性分析表明老年性缺血性脑卒中后抑郁神经功能康复与抑郁症改善两者之间并无直线相关关系(P>0.05)。TESS评定结果显示治疗后2周末观察组评分明显高于对照组(P<0.05),10周末两组评分比较差异无统计学意义(P>0.05)。结论:对PSD患者给予抑郁干预治疗能够促进其神经功能的康复,同时也对卒中后抑郁症状的改善有明显疗效,副作用呈一过性,耐受性好,值得在脑卒中康复的临床应用中进一步推广。

Objective： To investigate the effects of antidepressant treatment effect on the recovery of neurological function in post-stroke depression（PSD） after ischemic stroke in elderly patients.Methods： A total of 40 eligible patients were randomly divided into observation group and control group with 20 patients in each group.Both groups were treated with routine therapy while the observation group was given an extra antidepressant agent of Prozac at the dosage of 20mg/d.After an treatment course of 10 weeks,DNF and HAMD assessment system were used to evaluate and compare clinical effects of both groups.At the end of 2rd and 10th week,TESS was used for side effects evaluation.Results： The treatment group showed significant decrease in DNF and HAMD scores comparing with the control group（P0.05）.But no straight lined correlations between the recovery of neurological function and the improvement of depression（P0.05） was found.After 2 weeks of treatment,the treatment group showed significant higher TESS scores comparing with the control group（P0.05）,while no significant difference was found after 10 weeks of treatment（P0.05）.Conclusions： Antidepressant treatment can help elderly patients with post-stroke depression after ischemic stroke to restore neurological function as well as improve symptoms.It′s well tolerated and produce only temporary side effects,thus it′s worth for application in large scale.