盐酸氟西汀对急性脑卒中后抑郁患者的情绪及其血清单胺递质水平的影响

Effects of fluoxetine hydrochloride on mood and plasma NE,DA and 5-HT levels in patients with acut post-stroke depression

目的 探究急性脑卒中后抑郁患者应用盐酸氟西汀治疗的效果,及其对血浆多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)浓度的影响。方法 选取我科2020年5月~2022年7月期间114例急性脑卒中后抑郁患者作为研究对象,根据随机数字表法分为对照组57例给予常规治疗及心理干预,观察组57例联合盐酸氟西汀治疗,对比两组患者睡眠状况,血清神经递质水平,不良反应,心理状态,神经功能。结果 治疗后,观察组患者主观睡眠质量、睡眠紊乱、入睡时间、日间功能、睡眠效率及睡眠时间评分均低于对照组(P<0.05);观察组患者5-HT、DA及NE水平均高于对照组(P<0.05);观察组患者发生不良反应与对照组比较无统计学意义的差异(P>0.05);观察组汉密尔顿抑郁量表(HAMD)评分及美国国立卫生研究院卒中量表(NIHSS)评分均低于对照组(P<0.05)。结论 联合盐酸氟西汀治疗急性脑卒中后抑郁患者,能有效改善患者心理状态、睡眠状况,促进神经功能康复,提升血清神经递质水平,且具有较高的安全性。

Objective e To explore the effect of fluoxetine hydrochloride on mood and plasma dopamine(DA),norepinephrine(NE)and serotonin(5-HT)in acute post-stroke patients with depression.Methods 114 patients with acute post-stroke depression from May 2020 to July 2022 in our department were selected as research objects.57 patients in the control group received conventional treatment and psychological intervention,and 57 patients in the observation group received combined treatment with fluoxetine hydrochloride.The sleep status,serum neurotransmitter level,adverse reactions,psychological state and neurological function of the two groups were compared.Results After treatment,the dosage of hypnotic drugs,subjective sleep quality,sleep disorder,sleep time,daytime function,sleep efficiency and sleep time scores in the observation group were lower than those in the control group(P<0.05).The levels of 5-HT,DA and NE in the observation group were higher than those in the control group(P<0.05).There was no statistical significance in the adverse reactions between observation group and the control group(P>0.05).Hamilton Self-Rating Scale for Depression(HAMD)score and National Institutes of Health Stroke Scale(NIHSS)score in the observation group were lower than those in the control group(P<0.05).Conclusion Combined with fluoxetine hydrochloride in the treatment of acute post-stroke patients with depression can effectively improve the psychological state and sleep status of patients,promote the rehabilitation of neurological function,improve the level of serum neurotransmitter,and has a high safety.