艾司西酞普兰治疗对脑卒中后抑郁患者脑内神经递质、炎性因子及认知功能的影响

Effects of escitalopram treatment on neurotransmitters,inflammatory factors and cognitive function in patients with post-stroke depression

目的研究艾司西酞普兰治疗对脑卒中后抑郁患者脑内神经递质、炎性因子及认知功能的影响。方法收集2021年6月至2022年12月于中南大学湘雅医学院附属海口医院进行治疗的301例脑卒中后抑郁患者,根据治疗方式不同归为研究组(n=151,常规治疗联合艾司西酞普兰治疗)和对照组(n=150,常规治疗)。比较两组临床疗效[根据四级疗效及HAMD量表评分判定]、神经递质[包括谷氨酸(Glu)、天冬氨酸(Asp)、甘氨酸(Gly)、γ-氨基丁酸(GABA)]、炎性因子[包括肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)]、认知功能[使用蒙特利尔认知评估量表(MoCA)评估]及不良反应。结果研究组临床疗效(95.36%)显著高于对照组(84.66%),差异有统计学意义(P<0.05);治疗后研究组Glu、Asp水平低于对照组,Gly、GABA水平高于对照组,差异有统计学意义(P<0.05);治疗后研究组TNF-α、IL-6、CRP水平低于对照组,差异有统计学意义(P<0.05);治疗1个月及治疗后3个月后研究组MoCA评分高于对照组,差异有统计学意义(P<0.05);研究组不良反应率(5.96%)与对照组不良反应率(4.66%)比较差异无统计学意义(P>0.05)。结论采用艾司西酞普兰治疗脑卒中后抑郁患者的临床效果显著,其能够有效调节患者的神经递质平衡、降低患者的炎性因子水平,并且有助于恢复患者的认知功能,具有一定安全性,值得在临床上使用推广。

Objective To study the effects of escitalopram treatment on neurotransmitters,inflammatory factors and cognitive function in patients with post-stroke depression.Methods 301 patients with post-stroke depression who were treated in Haikou Hospital,Xiangya Medical College,Central South University from June 2021 to December 2022 were collected,and according to the different treatment methods,they were classified into the study group(n=151,conventional treatment combined with escitalopram treatment)and the control group(n=150,conventional treatment).The clinical efficacy[according to the fourlevel efficacy and HAMD scale score],neurotransmitters[including glutamic acid(Glu),L-aspartic acid(Asp),glycine(Gly),γ-Aminobutyrie Acid(GABA)],inflammatory factors[including Tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6),C-reactive protein(CRP)],cognitive function[using the Montreal Cognitive Assessment(MoCA)assessment]and adverse reactions of the two groups were compared.Results The clinical efficacy of the study group(95.36%)was significantly higher than that of the control group(84.66%),and the difference was statistically significant(P<0.05).After treatment,the levels of Glu and Asp in the study group were lower than those in the control group,and the levels of Gly and GABA were higher than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α,IL-6,and CRP in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).MoCA scores in the study group were higher than those in the control group after 1 month and 3 months after treatment,and the difference was statistically significant(P<0.05).There was not statistically significant between the adverse reaction rate of the study group(5.96%)and the control group(4.66%)(P>0.05).Conclusion The clinical effect of escitalopram in the treatment of patients with post stroke depression is significant.It can effectively regulate the balance of neurotransmitters,reduce the level of inflammatory factors in patients,and help the recovery of patients‘cognitive function.It has a certain safety and is worthy of clinical use and promotion.