文拉法辛对老年急性缺血性脑卒中后抑郁的效果

Effect of venlafaxine on depression after acute ischemic stroke in the elderly

目的 探讨老年急性缺血性脑卒中后抑郁患者应用文拉法辛的临床价值。方法 筛选70例老年急性缺血性脑卒中后抑郁患者(2020年6月~2021年12月),在“随机数字表法”原则下分2组--对照组与观察组,前者给予常规药物和曲唑酮治疗,后者常规药物联合文拉法辛治疗;评估并比较两组治疗结果(临床总疗效、抑郁程度、认知功能、血清因子水平、生活质量、不良反应发生率)。结果 与对照组相比,观察组治疗总有效率明显较高(94.29%vs77.14%),观察组健康状况调查简表(SF-36)(角色、社会、躯体、认知)评分均更高(P<0.05);两组不良反应发生率比较(P>0.05);两组治疗后血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)水平及汉密尔顿抑郁量表(HAMD)评分、简易智力状态检查量表(MMSE)评分均明显改善,观察组治疗后CRP、Hcy水平均较对照组更高,且观察组HAMD评分更低,MMSE评分更高(P<0.05);两组治疗后的美国国立卫生研究院卒中量表(NIHSS)评分较治疗前均所有下降,观察组评分更优(P<0.05)。结论 对于老年急性缺血性脑卒中后抑郁患者应用文拉法辛,可增强整体疗效,改善患者抑郁程度,调节血清相关因子水平,提高患者认知功能。

Objective To explore the clinical value of venlafaxine in elderly patients with acute ischemic poststroke depression. Methods 70 elderly patients with acute ischemic post-stroke depression(June 2020 to December 2021) were selected and divided into two groups under the principle of "random number table method"-control group and observation group. The former was treated with conventional drugs and the latter was treated with conventional drugs combined with venlafaxine;The treatment results of the two groups(total clinical efficacy,degree of depression,cognitive function,serum factor level,quality of life and incidence of adverse reactions)were evaluated and compared between the two groups. Results Compared with the control group,the total effective rate of the observation group was significantly higher(94.29% vs 77.14%),and the scores of SF-36(role,society,body and cognition)in the observation group were higher(P<0.05). The incidence of adverse reactions in the two groups was not difference(P>0.05).After treatment,the levels of serum C-reactive protein(CRP),homocysteine(Hcy) and the scores of Hamilton Depression Scale(HAMD) and mini mental state examination(MMSE)in the two groups were significantly improved. The levels of CRP and Hcy and the MMSE score in the observation group were higher than those in the control group,and HAMD score in the observation group were lower(P<0.05). The National Institutes of Health Stroke Scale(NIHSS) scores of the two groups after treatment were all lower than before treatment,and the scores of NIHSS in the observation group were better(P<0.05). Conclusion The application of venlafaxine in elderly patients with post-stroke depression after acute ischemic stroke can enhance the overall curative effect,improve their degree of depression,adjust the level of serum related factors,improve their cognitive function.