抗抑郁药物对脑血管病所致精神障碍患者负性情绪及生活质量的影响

Effect of antidepressant on negative emotion and quality of life in patients with mental disorder caused by cerebrovascular disease

目的探讨抗抑郁药物改善脑血管病所致精神障碍患者负性情绪及生活质量的效果。方法选取2015年6月至2016年6月本院收治的脑血管病所致精神障碍患者112例，采用随机数字表法分为干预组及对照组，每组56例。对照组采用帕罗西汀治疗，干预组采用艾司西酞普兰治疗。治疗前及治疗6周末，采用汉密尔顿抑郁量表（HAMD）（17项版）评价两组患者的抑郁情况，采用Loeweistein作业治疗认知评定（LOTCA）评价两组患者的认知功能，采用卡氏行为状态评分表（KPS）评价两组患者的活动状态，采用生活质量核心量表（QLQ—C30）评价两组患者生活质量。结果治疗前，两组患者HAMD、LOTCA、KPS及QLQ-C30评分比较差异均无统计学意义（均P〉0．05）。治疗6周末，干预组HAMD评分明显低于对照组[（13．28±2．12）比（19．66±2．85），P〈0．05]，干预组LOTCA评分[（98．76±5．05）比（73．38±7．44）]、KPS评分[（85．52±7．21）比（71．36±6．84）1均明显高于对照组（均P〈0．05），干预组QLQ-C30量表中的躯体功能、心理功能、社会功能、总体生活质量的评分均优于对照组（均P〈0．05）。结论抗抑郁药物艾司西酞普兰治疗脑血管病所致精神障碍患者的效果优于帕罗西汀，可有效改善患者的负性情绪，提高患者的生活质量，值得应用。

Objective To study the effect of antidepressant in improving negative emotion and life quality of patients with mental disorder caused by cerebrovascular disease. Methods 112 patients with mental disorder caused by cerebrovascular disease in our hospital from June, 2015 to June, 2016 were randomly divided into experimental group （n=56） and control group （n=56）. The patients in the experimental group were treated with escitalopram, while the patients in the control group were treated with paroxetine. Hamilton Depression Scale （HAMD）, Loeweistein occupational fllerapy cognitive assessment （LOTCA）, Karnofsky performance score （KPS）, quality of life core scale （QLQ-C30） were analyzed before and 6 weeks after treatment respectively. Results There were no statistically significant differences in HAMD, LOTCA, KPS, and QLQ -C30 scores between the experimental group and the control group before treatment （P〉0.05）; 6 weeks after treatment, HAMD score in the experimental group were significantly lower than that in the control group [（13.28±2.12） vs.（19.66±2.85）, P〈0.05], LOTCA, KPS scores in the experimental group were significantly higher than those in the control group [（98.76±5.05） vs.（73.38±7.44）, （85.52±7.21） vs.（71.36±6.84）; P〈0.05], and the scores of body function, psychological function, social function, and overall quality of life in QLQ-C30 in the experimental group were significantly higher than those in the control group （P〈0.05）. Conclusion Antidepressant escitalopram indeed improve negative emotion and quality of life of patients with mental disorder caused by cerebrovascular disease.