依达拉奉联合阿替普酶对急性缺血性脑卒中后抑郁伴睡眠障碍患者的影响

Effects of edaravone combined with alteplase on the depression emotion and life quality of patients with acute ischemic stroke complicated by sleep disorders

目的研究依达拉奉联合阿替普酶对急性缺血性脑卒中(AIS)后抑郁伴睡眠障碍患者的影响。方法将2017年1月至2020年7月确诊并接受治疗的64例AIS后抑郁伴睡眠障碍患者纳入研究范围,随机分为对照组和联合组,每组32例。对照组接受注射用阿替普酶治疗,联合组在对照组基础上加用依达拉奉治疗。疗程均为2周。观察2组抑郁情绪、睡眠障碍、生活质量及血清神经递质[去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)]、炎性因子[白介素1β(IL-1β)、IL-18]、性激素[催乳素(PRL)、孕酮(P)、雌二醇(E2)]变化。结果治疗前,2组HAMD评分、SDS评分、PSQI评分、SS-QOL评分、NE、DA、5-HT、IL-1β、IL-18、PRL、P、E2比较差异无统计学意义(P>0.05);治疗后,2组HAMD评分、SDS评分、PSQI评分、NE、DA、5-HT、IL-1β、IL-18、PRL、P、E2显著低于治疗前,SS-QOL评分显著高于治疗前(P<0.05);与对照组治疗后比较,联合组治疗后HAMD评分、SDS评分、PSQI评分、NE、DA、5-HT、IL-1β、IL-18、PRL、P、E2显著降低,SS-QOL评分显著升高(P<0.05)。结论依达拉奉联合阿替普酶治疗AIS后抑郁伴睡眠障碍患者,能够改善患者抑郁情绪、睡眠障碍和生活质量,并调控神经递质、炎性因子和性激素分泌。

Objective To investigate the effects of edaravone combined with alteplase on the depression emotion and life quality of patients with acute ischemic stroke(AIS)complicated by sleep disorders.Methods A total of 64 patients with AIS who were treated in our hospital from January 2017 to July 2020 were enrolled in the study,who were randomly divided into control group and observation group,with 32 cases in each group.The patients in control group were received intravenous thrombolysis with alteplase,however,those in observation group on the basis of control group,were treated by edaravone,with a treatment course of two weeks for both groups.After treatment,the depression status,sleep disorders,life quality,and serum levels of neurotransmitters(NE,DA and 5-HT),inflammatory cytokines(IL-1βand IL-18)and sex hormones(PRL,P and E2)were observed and compared between the two groups.Results Before treatment,there were no significant differences in the indexes mentioned above between the two groups(P>0.05).After treatment the HAMD scores,SDS scores,PSQI scores,and serum levels of NE,DA,5-HT,IL-1β,IL-18,PRL,P and E2 in both groups were significantly decreased,however,SS-QOL scores were significantly increased(P<0.05).Moreover the decrease degree and increase degree in observation group were more significant than those in control group(P<0.05).Conclusion Edaravone combined with alteplase in treatment of AIS complicated by depression and sleep disorders can significantly improve the depression status,sleep disorders and life quality of patients,and can regulate the expression levels of neurotransmitters,inflammatory cytokines and sex hormones.