舍曲林对脑卒中后抑郁患者血清细胞因子水平的影响及疗效观察

Influence and efficacy of sertraline on serum cytokine levels in patients with depression after stroke

目的探讨舍曲林对脑卒中后抑郁(PSD)患者血清细胞因子水平的影响及疗效观察。方法 80例PSD患者随机分为舍曲林组和对照组。两组均予以脑血管病常规治疗和康复训练。舍曲林组加用舍曲林治疗,对照组加用阿米替林治疗,疗程均为8周。结果治疗8周后,两组患者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-1β(IL-1β)水平较前均有明显下降(P<0.05或P<0.01),且舍曲林组下降值较对照组更明显(P<0.05);舍曲林组临床总有效率(95.0%)明显高于对照组(77.5%)(χ2=5.16,P<0.05)。结论舍曲林治疗PSD具有较好的疗效,作用机制与其降低血清TNF-α、IL-6和IL-1β水平,纠正炎症细胞因子网络失衡密切相关。

Objective To discuss the influence and efficacy of sertraline on serum cytokine levels of patients with poststroke depression （PSD）. Methods Eighty cases of PSD patients were divided into sertraline group and control group randomly. The patients in two groups were given routine treatment and rehabilitation training for cerebrovascular disease. The patients in sertraline group were additionally given sertraline for 8 weeks, while the patients in control group were given amitriptyline for 8 weeks otherwise. Results After 8 weeks＇ medical treatment, the serum tumor necrosis factor-α （TNF-α）, Interleukin-6 （IL-6） and Interleukin-1β （IL-1β） levels of patients in two groups were declined obviously than before （P 〈 0.05 or P 〈 0.01）, and the declining rate in sertraline group was much lower than that in control group （P 〈 0.05）. The total clinical efficiency of patients in sertraline group （95.0%） was much higher than that in control group （77.5%）（X2=5.16, P 〈 0.05）. Conclusion Sertraline, as the ideal drug to treat PSD, has reliable curative effect on PSD, whose mechanism of action has close relationship with the reduction of serum TNF-α, IL-6 and IL-1β levels and the correction of network imbalance of inflammatory cytokines.