舍曲林早期干预对脑梗死后抑郁状态及神经功能的影响

The effects of sertraline early intervention on post stroke depression and neural functional recovery

目的分析舍曲林早期干预对脑梗死后抑郁状态、神经功能、生活质量的影响。方法将卒中后抑郁患者78例随机分为干预组和对照组,每组39例。对照组给予常规治疗,干预组在对照组治疗的基础上给予舍曲林早期干预。比较2组治疗前后抑郁量表(HAMD)评分、卒中量表(NIHSS)评分、日常生活能力量表(ADL)评分及血浆P物质(SP)、神经肽Y(NPY)水平。结果治疗前2组患者HAMD、NIHSS、ADL评分比较差异均无统计学意义(P>0.05);治疗后2组HAMD、NIHSS、ADL评分均改善,且干预组患者HAMD、NIHSS评分明显低于对照组,ADL评分明显高于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前血浆SP及NPY水平比较差异均无统计学意义(P>0.05);治疗后2组血浆SP及NPY均改善,且干预组血浆SP水平明显低于对照组,血浆NPY水平明显高于对照组,差异均有统计学意义(P<0.05)。结论舍曲林早期干预能有效缓解脑梗死患者急性期抑郁状态,促进患者神经功能恢复,提高患者总体生活质量。患者抑郁状态的改善可能与舍曲林治疗后血浆SP和NPY的动态改变相关。

Objective To analyse the effects of antidepressant sertraline early intervention on depressive state,neuro- logical deficits and life quality after cerebral infarction. Methods 78 patients with post-stroke depression were randomly divid- ed into intervention group（ n = 39 ） and control group（ n = 39）. Control group was given conventional treatment, on the basis of the control group, intervention group was given sertraline early intervention. The HAMD score, NIHSS score, ADL score, plasma SP and NPY were compared between the two groups before and after treatment. Results There was no significant difference in HAMD,NIHSS and ADL scores between the two groups before treatment （ P 〉 0.05） ; After treatment, the scores of HAMD, NIHSS and ADL improved in both groups, and the score of HAMD and NIHSS in the intervention group was significantly lower than that in the control group, the ADL score was significantly higher than that in the control group（ P 〈 0. 05 ）. There were no significant differences in plasma SP and NPY levels between the two groups before treatment（ P 〉 0.05 ）. After treatment, plas- ma SP and NPY were improved in both groups,and plasma SP level in intervention group was significantly lower than that in control group. Plasma NPY The level was significantly higher than the control group, the difference was statistically significant （P 〈 0.05 ）. Conclusion Sertraline early intervention can effectively alleviate the acute phase of depression in patients with cerebral infarction, promote neurological functional recovery and improve the quality of life. The remission of PSD may be relat- ed to changes of SP and NPY after Seculin treatment.