重复经颅磁刺激对脑卒中后失语症合并抑郁患者的影响

The Effect of Repeated Transcranial Magnetic Stimulation on Post-Stroke Aphasia With Depression Patients

目的分析脑卒中后失语症合并抑郁患者遵医嘱予以重复经颅磁刺激对其生活质量和抑郁情绪的影响。方法选取2021年4月—2022年3月厦门大学附属第一医院收治的脑卒中后失语症合并抑郁患者90例,根据随机双盲法分为对照组与研究组,各45例。研究组遵医嘱予以重复经颅磁刺激干预治疗+服用抗抑郁症药物治疗,对照组予以常规康复和基础药物疗法。2组均干预治疗1个月,对全部患者干预前后的日常生活能力(activity of daily living,ADL)予以改良Barthel指数评分(modified Barthel index,MBI)评估;予以医院版卒中失语抑郁问卷(stroke aphasic depression questionnaire hospital version,SADQ-H)、失匹配负波(mismatch negative,MMN)分析2组干预前后的抑郁状态。结果干预前,2组的MBI评分、SADQ-H评分比较,差异无统计学意义(P>0.05);干预后,与对照组MBI(60.3±4.4)分相比,研究组的MBI评分(72.7±6.7)分更高,而对照组SADQ-H评分(31.3±6.4)分,研究组SADQ-H评分(26.6±5.7)分更低(P<0.05)。干预前,2组的MMN波幅、MMN潜伏期比较,差异无统计学意义(P>0.05);干预后,与对照组相比,研究组MMN波幅明显增高,而MMN潜伏期明显下降,差异有统计学意义(P<0.05)。结论脑卒中后失语症合并抑郁状态予以重复高频经颅磁刺激可改善其抑郁状态,提升患者的生活质量。

Objective To analyze the effect of repeated transskull magnetic stimulation on quality of life and depression in patients with aphasia after stroke.Methods A total of 90 patients with aphasia complicated with depression after stroke were enrolled in the First Affiliated Hospital of Xiamen University From April 2021 to March 2022,they were randomly divided into control group and study group.The study group was given repeated transcranial magnetic stimulation intervention and antidepressant treatment according to the doctor's advice,while the control group was given routine rehabilitation and basic drug therapy.The two groups were treated for 1 month.The ADL of all patients before and after the intervention was evaluated by modified Barthel index(MBI).stroke aphasic depression questionnaire hospital version(SADQ-H)and mismatch negative(MMN)were used to analyze the depression status before and after intervention.Results Before the intervention,there was no significant difference in MBI score and SADQ-H score between the two groups(P>0.05).After the intervention,compared with the MBI score of the control group(60.3±4.4)points,the MBI score of the study group was higher(72.7±6.7)points,while the SADQ-H score of the control group was(31.3±6.4)points and the SADQ-H score of the study group was lower(26.6±5.7)points(P<0.05).There was no significant difference in MMN amplitude and MMN latency between the two groups before intervention(P>0.05).After the intervention,compared with the control group,the amplitude of MMN in the study group increased significantly,while the latency of MMN decreased significantly,with statistical significance(P<0.05).Conclusion Repetitive high frequency transcranial magnetic stimulation can improve the quality of life of patients with poststroke aphasia complicated with depression.