艾司西酞普兰治疗脑梗死后抑郁患者的效果及对神经递质的影响

Effect of escitalopram on patients with depression after cerebral infarction and its influence on neurotransmitters

目的探讨艾司西酞普兰治疗脑梗死后抑郁患者的疗效及对神经递质的影响。方法本研究对象为我院2018年8月~2020年8月100例脑梗死后抑郁患者,按数字表法随机分为两组,对照组患者采用神经内科治疗以及常规心理干预,观察组在对照组基础上采用艾司西酞普兰治疗。比较治疗前、治疗1个月后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、中文版Barthel指数(BI)、美国国立卫生研究院卒中量表(NIHSS)以及血清神经递质水平。结果两组治疗后HAMD评分、HAMA评分均显著下降,观察组治疗后两项评分均显著低于对照组(P<0.05);两组治疗后NIHSS评分降低、BI评分升高,观察组治疗后NIHSS评分低于对照组,BI评分高于对照组(P<0.05);两组治疗后血清多巴胺(DA)、5-羟色胺(5-HT)水平、去甲肾上腺素(NE)水平均上升,治疗后观察组均显著高于对照组(P<0.05)。结论艾司西酞普兰能够显著降低脑梗死后抑郁患者的焦虑、抑郁情绪,改善患者神经功能以及活动功能,并能促进保护性神经递质的分泌与释放。

Objective To investigate the effect of escitalopram on depression after cerebral infarction and its effect on neurotransmitters.Methods A total of 100 patients with post cerebral infarction depression from August 2018 to August 2020 in our hospital were the subjects of this study,and randomly divided into two groups using the number table method.Patients in the control group were treated with neurology as well as with routine psychological interventions,and patients in the observation group were treated with escitalopram on a control group basis.Before treatment,1 month after treatment,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Barthel index of Chinese Version(BI),National Institutes of Health Stroke Scale(NIHSS),as well as serum neurotransmitter levels were compared.Results HAMD score and HAMA score were significantly decreased after treatment in both groups,and both scores were significantly lower after treatment in the observation group than in the control group(P<0.05).The NIHSS score decreased and BI score increased after treatment in both groups,and the NIHSS score was lower and BI score was higher after treatment in the observation group than in the control group(P<0.05).Serum levels of dopamine(DA),serotonin(5-HT),and norepinephrine(NE)increased after treatment in both groups and were significantly higher in the observation group after treatment(P<0.05).Conclusion Escitalopram can reduce anxiety and depression,improve neurological as well as active function in patients with post cerebral infarction depression,and can promote their secretion and release of protective neurotransmitters.