抗抑郁治疗对老年脑卒中后抑郁患者神经功能康复及神经元特异性烯醇化酶的影响

Effect of antidepression therapy on recovery of nerve function and neuron-specific enolase in elderly poststroke depression patients

目的观察抗抑郁治疗对老年脑卒中后抑郁(post-stoke depression,PSD)患者神经功能康复和神经元特异性烯醇化酶(neuron-specific enolase,NSE)的影响。方法选择2015年7月~2018年6月眉山市人民医院神经内科收治的老年脑卒中合并PSD患者119例,按照入院顺序随机双盲试验设计,分为治疗组60例和对照组59例,动态观察2组抗抑郁治疗前,治疗后2、4、8周及6个月美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分和NSE水平的差异。结果 2组治疗后2、4、8周及6个月HAMD评分和NIHSS评分较治疗前明显降低,差异有统计学意义(P<0.05)。治疗组治疗后2、4、8周及6个月HAMD评分明显低于对照组,差异有统计学意义(P<0.01)。治疗组治疗后4、8周及6个月NIHSS评分明显低于对照组,差异有统计学意义(P<0.05,P<0.01)。治疗组治疗后2、4、8周血清NSE水平明显低于对照组,差异有统计学意义[(28.70±2.38)μg/L vs (30.78±2.72)μg/L,(24.16±2.45)μg/L vs (26.12±3.02)μg/L,(13.17±2.60)μg/L vs (15.94±3.39)μg/L,P<0.01]。Person相关性分析显示,治疗前血清NSE水平与NIHSS评分呈正相关(r=0.459,P<0.01)。结论抗抑郁治疗可改善老年PSD患者的抑郁症状,促进神经功能恢复,早期血清NSE水平可作为神经功能康复的预测指标。

Objective To study the effect of antidepression therapy on the recovery of nerve function and neuron-specific enolase(NSE)in elderly poststoke depression(PSD)patients.Methods One hundred and nineteen elderly PSD patients admitted to our hospital from July 2015 to June2018 were divided into treatment group(n=60)and control group(n=59)according to the random double-blind test.The national institute of health stroke scale(NIHSS)and Hamilton depression scale(HAMD)scores were recorded and the serum NSE level was measured before treatment and at weeks 2,4,8 and 6 after treatment.Results The HAMD and NIHSS scores were significantly lower in two groups and were significantly lower in treatment group than in control group after treatment(P<0.05,P<0.01).The serum NSE level was significantly lower in treatment group than in control group after treatment(28.70±2.38μg/L vs 30.78±2.72μg/L,24.16±2.45μg/L vs 26.12±3.02μg/L,13.17±2.60μg/L vs 15.94±3.39μg/L,P<0.01).Pearson correlation analysis showed that the serum NSE level was positively related with the NIHSS score before treatment(r=0.459,P <0.01).Conclusion Antidepression treatment can improve the symptoms of depression and the recovery of nerve function in elderly PSD patients.The serum NSE level can predict the recovery of nerve function in elderly PSD patients.