氟西汀对缺血性脑卒中患者血清脑源性神经营养因子水平的影响及临床疗效观察

Influence and clinical effect of fluoxetine on the level of serum brain-derived neurotrophic factor in patients with ischemic stroke

目的观察氟西汀治疗缺血性脑卒中患者血清脑源性神经营养因子(BDNF)的变化及神经运动功能恢复情况。方法将60例缺血性脑卒中的患者随机分为氟西汀组和对照组,2组患者均同时接受物理治疗。采用酶联免疫吸附法(ELISA)测定治疗前后BDNF的变化,并与对照组比较;用改良Barthel指数(MBI)和简化Fug-lMeyer运动功能量表(FMA)评定2组患者的日常生活活动能力(ADL)和运动功能。结果治疗3个月后,氟西汀组BDNF浓度显著高于治疗前及对照组(P<0.05);治疗后2组MBI及FMA评分均有改善(P<0.05),且氟西汀治疗组疗效优于对照组(P<0.05)。结论缺血性脑卒中患者早期给氟西汀和物理治疗后可促进其运动功能的恢复,提高日常生活活动能力,这种效应可能是通过提高BDNF的浓度,促进神经元再生和对抗神经元损伤后凋亡而发挥作用。

Objective To observe the changes and neuromotor functional recovery condition of fluoxetine in treating serum brain-derived neurotrophic factor （BDNF） of ischemic stroke pa- tients. Methods 60 ischemic stroke patients were randomly divided into fluoxetine group and con- trol group, and all patients were given physical therapy. Enzyme-linked immunosorbent assay （ELISA） was adopted to detect BDNF changes before and after treatment; modified Barthel index （MBI） and simple Fugl-Meyer assessment （FMA） were used to assess ability of activities of daily living（ADL） and motor functions for both of 2 groups. Results 3 months after treatment, BDNF concentration of fluoxetine group was significantly higher than before treatment（same group） and that of control group （P 〈 0.05）. After treatment, MBI and FMA scores in both of 2 groups im- proved （P 〈 0.05）, and the therapeutic effect of fluoxetine group was better than control group. Conclusion Application of fluoxetine and physiotherapy in treatment of ischemic stroke patients in a early stage can significantly enhance their motor functional recovery and daily living functions, and effects maybe performed by increasing BNDF concentration, promoting neuronal regeneration and resisting apoptosis after neural lesion.