左洛复治疗脑卒中后抑郁的临床疗效与P300的关系

Efficacy of zoloft in treatment of post-stroke depression and its relation to cognitive potential-P300

目的评价抗抑郁药物左洛复对脑卒中后抑郁(post-stroke depression,PSD)患者的临床疗效与P300的关系。方法对2010年1月至2012年7月收治入院的脑卒中后抑郁患者216例,分为对照组(n=146)及治疗组(n=70)。所有患者均给予规范的脑卒中治疗,在治疗组患者中加用左洛复50 mg/d口服,连续治疗8周。治疗组又根据P300测定结果分为P300阳性和P300阴性两组。观察基线、4周及8周时各组的神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)、NIHSS运动功能、HAMD及Fugl-Meyer运动功能评分(FuglMeyer motor scale,FMMS)变化。结果治疗8周后,治疗组HAMD评分、NIHSS运动功能评分及FMMS较对照组均有明显改善,差异有统计学意义(P<0.05)。而P300阴性组与P300阳性组相比,改善更为明显,差异有统计学意义(P<0.05),但NIHSS总分变化两组并没有明显差异(P>0.05)。结论左洛复改善脑卒中后抑郁患者抑郁症状的同时,可以改善神经功能缺损、促进神经功能恢复,且与患者P300密切相关。

Objective To evaluate the efficacy of antidepressant drug zolofl in treatment of post- stroke depression and its relation to cognitive potential-P300. Methods Two hundred and sixteen patients with post-stroke depression admitted from January 2010 to July 2012 were enrolled in this study. Patients were divided into test group （n = 146） and control group （n = 70）. All patients were given the conventional stroke treatment, and for those in test group zoloft 50 mg per day was added with for 8 weeks. According to results of cognitive potential-P300 examination patients in test group were further divided into P300 positive and P300 negative groups. The changes National Institules of Health Stroke Scale （NIHSS） score, Hamilton Depression Scale （HAMD） and Fugl-Meyer motor scores （FMMS） for baseline were observed 4 weeks and 8 weeks after treatment. Results After 8 weeks of treatment, the HAMD, NIHSS motor function score, FMMS score in test group were significantly more improved than those in control group （P 〈 0.05 ）. Compared to P300 positive group the improvement in P300 negative group was more markedly （ P 〈 0.05 ） ; however, there was no significant difference in NIHSS score between two groups （ P 〉 0. 05 ）. Conclusion Zoloft can effectively improve depressive symptoms and motor deficit for patients with post-stroke depression, which is closely related to P300.