西酞普兰对脑卒中后抑郁患者认知功能与负面情绪的影响

Effect of citalopram on post-stroke depression patients and its impact on cognitive function and negative emotions

目的探讨脑卒中后抑郁患者应用西酞普兰的疗效及其对认知功能和下丘脑-垂体-肾上腺素轴功能(HPA)的影响。方法将我院2017年1月至2018年6月期间收治的97例脑卒中后抑郁患者,依据随机数字表法分为对照组48例及观察组49例,对照组患者给予脑血管病常规对症康复治疗,观察组患者增加西酞普兰口服治疗,两组患者均持续治疗8周,观察治疗后两组患者的下丘脑-垂体-肾上腺素轴功能、神经功能、认知功能、血清细胞因子、抑郁情绪变化,并对比疗效及安全性。结果观察组TNF-α、IL-6、IL-2、Cor、CRH、ACTH、Hcy水平及神经功能、HAMD评分均低于对照组,MoCA评分及总有效率高于对照组(P<0.05);TESS评分两组无差异(P>0.05)。结论西酞普兰能够有效改善脑卒中后抑郁患者HPA轴功能,调节血清细胞因子水平,缓解负面情绪,促进神经功能及认知功能恢复,安全性好。

Objective To analyze the effects of citalopram on depression,negative depression,cognitive function and hypothalamic-pituitary-adrenalin function(HPA)in patients with post-stroke depression.Methods Ninetyseven patients with post-stroke depression who were admitted to our hospital from January 2017 to June 2018 were randomly divided into the control group(n=48)and the observation group(n=49).The control group received routine symptomatic cerebrovascular disease,the patients in the observation group were treated with citalopram orally.The patients in both groups were treated for 8 weeks.The hypothalamic-pituitary-adrenalin function,neurological function,cognitive function,serum cytokines and depression were observed.And the clinical efficacy and safety were compared.Results The levels of TNF-α,IL-6,IL-2,Cor,CRH,ACTH,Hcy,neurological function and HAMD in the observation group were lower than those in the control group.The MoCA score and total effective rate in the observation group were higher than those in the control group(P<0.05).The TESS score in two groups was not difference(P>0.05).Conclusion Citalopram can effectively improve HPA axis function in patients with post-stroke depression,regulate serum cytokine levels,alleviate negative emotions,promote neurological function and cognitive function recovery,and have high safety.