艾司西酞普兰对急性缺血性卒中患者认知功能恢复的影响

Effect of Escitalopram for Cognitive Recovery after Acute Ischemic Stroke

目的探讨艾司西酞普兰对急性缺血性卒中患者认知功能恢复的影响。方法选取2011-07-01—2013-06-30厦门大学附属第一医院神经内科收治的急性缺血性卒中患者80例,将其随机分成安慰剂组和艾司西酞普兰,各40例,分别接受安慰剂和艾司西酞普兰治疗,均每日晨口服安慰剂或艾司西酞普兰1片,治疗90 d。采用蒙特利尔认知评估量表(MoCA)、Barthel指数(BI)、汉密尔顿抑郁量表(HAMD)评定患者治疗前及治疗90 d时的认知功能、日常生活能力及抑郁程度;治疗结束时比较两组患者卒中后抑郁发生率。结果治疗前两组患者MoCA评分、BI、HAMD评分间无差异(P>0.05);治疗后,艾司西酞普兰组MoCA评分、BI均高于安慰剂组(P<0.05),而HAMD评分低于安慰剂组(P<0.05);艾司西酞普兰组卒中后抑郁发生率低于安慰剂组〔11.1%(4/36)与40.5%(15/37),P<0.05〕。治疗期间两组均未出现严重的不良反应。结论早期应用艾司西酞普兰治疗,有利于急性缺血性卒中后患者认知功能的恢复和日常生活能力的提高,可使抑郁程度明显减轻,并可以降低卒中后抑郁发生率,而且患者耐受性良好,不良反应少。

ObjectiveToobservetheeffectofescitalopramforcognitiverecoveryafteracuteischemicstroke.Methods 80patientswithacuteischemicstrokeandcognitiveimpairmentadmittedtothedepartmentofneurologyoftheFirstAffiliated Hospital of Xiamen University from July 1st, 2011 to June 30th, 2013 were randomly divided into placebo group and escitalopram group, with each group 40 cases.The patients in the two groups were given one tablet of placebo and escitalopram respectively each morning for 90 days.Montreal cognitive assessment （ MoCA ） , Barthel index （ BI ） and Hamilton depression scale （ HAMD） were used to evaluate the cognitive function , activity of daily living and depression degree before treatment and after 90 days treatment.The depression degree after treatment was also compared between the two groups .Results The MoCA score, BI and HAMD score of the two groups before treatment showed no statistically significant difference （P〉0.05） .After treatment, the MoCA score and BI of escitalopram group were higher than the placebo group （ P〈0.05 ） , but the HAMD score was lower than the placebo group （ P〈0.05） .The incidence of post -stroke depression rate in escitalopram group was lower than the pla-cebo group 〔11.1% （4/36） vs.40.5% （15/37）, P〈0.05〕 .No severe adverse effects were shown in the two groups during treatment.Conclusion Early application of escitalopram is conducive to cognitive recovery after acute ischemic stroke and the im -provement of daily living activity.Besides, it can also restrict depression and reduce the incidence of post -stroke depression, with patients having satisfactory tolerance and few adverse effect .