艾司西酞普兰对脑梗死后抑郁症患者心理状态的影响

Effect of escitalopram on mental state of patients with post-cerebral infarction depression

目的探析脑梗死后抑郁症(PCID)患者采用艾司西酞普兰治疗的临床效果。方法随机选取92例PCID患者为对象,奇偶法分为对照组和观察组,各46例。两组均接受脑梗死常规对症治疗,对照组增加氟哌噻吨美利曲辛治疗,观察组增加艾司西酞普兰治疗。比较两组神经功能、心理状态、神经递质与临床疗效。结果观察组总有效率97.83%高于对照组的80.43%(P<0.05);治疗后,观察组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分(4.12±0.12)、(4.11±0.36)分较对照组的(7.36±0.65)、(7.63±1.23)分低,简易智力状态检查量表(MMSE)评分(26.25±3.15)分较对照组的(23.15±1.24)分高(P<0.05)。治疗后,观察组美国国立卫生研究院卒中量表(NIHSS)评分(4.12±0.13)分较对照组的(6.12±0.52)分低,Barthel指数(BI)评分(76.49±4.62)分较对照组的(72.25±2.36)分高(P<0.05);治疗后,观察组进食、洗澡、修饰、穿衣、控制大便、控制小便、如厕、床椅转移、平地行走、上下楼梯评分分别为(8.56±0.36)、(8.69±0.45)、(8.69±0.63)、(8.78±0.46)、(8.82±0.15)、(8.96±0.32)、(8.88±0.25)、(9.11±0.56)、(8.68±0.46)、(8.89±0.47)分,高于对照组的(7.69±0.65)、(7.71±0.33)、(7.63±0.34)、(7.89±0.34)、(7.25±0.64)、(8.12±0.11)、(7.96±0.15)、(7.86±0.13)、(7.89±0.31)、(7.86±0.36)分(P<0.05)。观察组不良反应发生率2.17%低于对照组的17.39%(P<0.05)。结论在脑梗死常规对症基础上,PCID患者治疗中使用艾司西酞普兰的效果显著,能快速改善患者神经功能,提高患者日常生活能力,缓解焦虑、抑郁症状,提高患者认知功能,具有较高的用药安全性。

Objective To explore the the clinical efficacy of escitalopram treatment in patients with post-cerebral infarction depression(PCID).Methods A total of 92 PCID patients as study subjects were divided into a control group and an observation group by odd-even method,with 46 cases in each group.Both groups received conventional symptomatic treatment for cerebral infarction,the control group was treated with flupentixol melitracen,and the observation group was treated with escitalopram.The neurological function,mental state,neurotransmitter and clinical effect of the two groups were compared.Results The total effective rate of 97.83%in the observation group was higher than 80.43%in the control group(P<0.05).After treatment,the scores of Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)in the observation group were(4.12±0.12)and(4.11±0.36)points,which were lower than(7.36±0.65)and(7.63±1.23)points in the control group;and the score of Mini-Mental State Examination(MMSE)of(26.25±3.15)points in the observation group was higher than(23.15±1.24)points in the control group(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)score of(4.12±0.13)points in the observation group was lower than(6.12±0.52)points in the control group,and Barthel index(BI)score of(76.49±4.62)points was higher than(72.25±2.36)points in the control group(P<0.05).After treatment,the scores of feeding,bathing,grooming,dressing,stool control,urination control,toilet use,bed chair transfer,flat walking and stairs were(8.56±0.36),(8.69±0.45),(8.69±0.63),(8.78±0.46),(8.82±0.15),(8.96±0.32),(8.88±0.25),(9.11±0.56),(8.68±0.46)and(8.89±0.47)points in the observation group,which were higher than(7.69±0.65),(7.71±0.33),(7.63±0.34),(7.89±0.34),(7.25±0.64),(8.12±0.11),(7.96±0.15),(7.86±0.13),(7.89±0.31)and(7.86±0.36)points in the control group(P<0.05).The incidence of adverse reactions of 2.17%in the observation group was lower than 17.39%in the control group(P<0.05).Conclusion On the basis of conventional symptomatic treatment for cerebral infarction,escitalopram in the treatment of PCID patients has significant effects,which can rapidly improve the neurological function of patients,improve their activities of daily living,relieve anxiety and depression symptoms,and improve cognitive function of patients.It has high drug safety.