大剂量阿托伐他汀预防缺血性脑卒中后抑郁的初步研究

A Preliminary Study of High-dose Atorvastatin in Prevention of Post-ischemic Stroke Depression

目的初步探究大剂量阿托伐他汀预防缺血性脑卒中后抑郁的临床疗效。方法选取2013年1月~2014年12月神经内科收治的78例缺血性脑卒中后抑郁患者为研究对象,按照入院顺序均分为观察组和对照组各39例,对照组给予基础治疗药物及常规量阿托伐他汀钙分散片治疗;观察组在对照组基础上给予大剂量阿托伐他汀钙分散片治疗,两组疗程均为一个月,比较治疗前后两组临床疗效,观察治疗前后两组患者汉密尔顿抑郁量表评分（HAMD）、神经功能缺损评分（SSS）、和日常生活能力评分（ADL）变化情况。结果治疗后观察组总有效率94.87%比对照组66.67%高,差异具有统计学意义（P〈0.05）。两组患者HAMD、SSS均较治疗前减小,BI较治疗前增大,观察组差异具有统计学意义（P〈0.05）,对照组无统计学意义（P〉0.05）;治疗后观察组HAMD（6.59±1.25）分、SSS（10.59±1.31）分均较对照组减小地更显著,BI（75.78±10.18）分较对照组增大地显著,差异具有统计学意义（P〈0.05）。结论大剂量阿托伐他汀对出血性脑卒中后抑郁患者预防作用疗效显著,改善患者神经功能缺损程度,同时改善脑卒中后抑郁患者抑郁程度,并且能够让患者恢复自主生活能力。大剂量阿托伐他汀对出血性脑卒中后抑郁患者预防作用具有临床应用价值。

Objective To explore the clinical effects of high- dose atorvastatin in the prevention of post- ischemic stroke depression. Methods 78 cases of patients with depression after ischemic stroke who were admitted in our hospital between January 2013 and December 2014 were selected as the study objects. According to the order of admission,the patients were divided into the observation group and the control group with 39 cases in each group. The control group was treated with basic drug therapy and routine dose of atorvastatin calcium dispersible tablets; Based on this,the observation group was treated with high- dose atorvastatin calcium dispersible tablets. Both of the two groups were treated for a month. The clinical curative effects were compared between the two groups. The changes of Hamilton Depression Scale scores（ HAMD）,neurological impairment scores（ SSS） and activity of daily living scores（ ADL） in the two groups before and after treatment were observed. Results After treatment,the total effective rate in the observation group（ 94. 87%） was higher than that in the control group（ 66. 67%）（ P〈0. 05）. HAMD and SSS scores in the two groups were lower than those before treatment while BI was higher than that before treatment. The differences in the observation group were statistically significant（ P〈0. 05） while in the control group were not statistically significant（ P〈0. 05）;After treatment,the decrease of HAMD（ 6. 59 ± 1. 25） and SSS（ 10. 59 ± 1. 31） in observation group was greater than that in the control group and the increase of BI（ 75. 78 ± 10. 18） was greater than that in the control group（ P〈0. 05）.Conclusions The effect of high- dose atorvastatin in preventing post- ischemic stroke depression is significant. It can relieve the degree of neurologic impairment and post- stroke depression. Besides,it can help patients restore the ability to live independently. It is of high application value.