艾司西酞普兰联合奥扎格雷钠治疗老年急性脑梗死合并焦虑抑郁障碍患者的临床观察

Clinical Observation of Escitalopram Citalopram Combined with Ozagrel Sodium for Elderly Patients with Acute Cerebral Infarction Complicated with Anxiety and Depression

目的：观察艾司西酞普兰联合奥扎格雷钠治疗老年急性脑梗死合并焦虑抑郁障碍患者的临床疗效及安全性。方法：选择老年急性脑梗死合并焦虑抑郁障碍患者140例,按随机数表法分为对照组和观察组,各70例。对照组患者采用常规治疗,并给予注射用奥扎格雷钠40~80 mg加入0.9%氯化钠注射500 ml中,ivgtt,bid;观察组患者在对照组基础上加服草酸艾司西酞普兰片10 mg,qd。两组患者均治疗8周。比较两组患者治疗前后汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、美国国立卫生院脑卒中量表（NIHSS）评分及Barthel（BI）指数,并观察临床疗效及不良反应发生情况。结果：两组患者治疗前HAMA、HAMD、NIHSS、BI指数及治疗1周后NIHSS、BI指数比较,差异均无统计学意义（P〉0.05）;观察组患者治疗1、4、8周后HAMA、HAMD评分及治疗4、8周后NIHSS、BI指数显著改善,对照组患者治疗4、8周后上述指标显著改善,且观察组改善程度显著优于对照组,差异均有统计学意义（P〈0.05）。观察组患者临床总有效率为87.14%,显著高于对照组的74.29%,差异有统计学意义（P〈0.05）。两组患者不良反应发生率比较,差异无统计学意义（P〉0.05）。结论：艾司西酞普兰联合奥扎格雷钠治疗老年急性脑梗死合并焦虑抑郁障碍患者的疗效显著,能明显改善患者的焦虑抑郁状态和神经功能,且安全性较好。

OBJECTIVE： To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly pa- tients with acute cerebral infarction complicated with anxiety and depression. METHODS： 140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method, with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9% Sodium chloride injection 500 ml, ivgtt, bid. Observation group was additionally given Escitalopram tablet 10 mg, qd. Both groups received treatment for 8 weeks. HAMA, HAMD, NIHSS and BI were compared between 2 groups before and after treatment, and clinical efficacy and the occurrence of ADR were observed. RESULTS： There was no statistical sig- nificance in HAMA, HAMD, NIHSS, BI before treatment and NIHSS, BI 1 week of after treatment between 2 groups （P〉0.05）. HAMA and HAMD of observation group 1, 4, 8 weeks after treatment, and NIHSS and BI of it 4, 8 weeks after treatment were improved significantly; above indexes of control group were improved significantly 4, 8 weeks after treatment, and the observation group was better than the control group, with statistical significance （P〈0.05）. The total effective rate of observation group was 87.14%, which was significantly higher than 74.29% of control group, with statistical significance （P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.06）. CONCLUSIONS： Escitalopram combined with ozagrel sodium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression, and can significantly improve anxiety, depression and neurological function with good safety.