艾司西酞普兰对卒中后抑郁的效果及对脑源性神经营养因子的影响

Effect of escitalopram on poststroke depression patients and its effect on brain-derived neurotrophic factor

目的探讨艾司西酞普兰应用于卒中后抑郁(PSD)的效果及对脑源性神经营养因子(BDNF)的影响。方法选取2019年2月~2022年9月收治的90例PSD患者为研究对象,依照干预方式分为心理组及药物组,各45例。两组均予基础对症治疗,心理组予心理干预,药物组增加艾司西酞普兰治疗,对比两组抑郁情绪,神经功能,生活质量,睡眠质量及不良反应发生情况。结果两组干预8周后汉密尔顿抑郁量表(HAMD),美国国立卫生研究院卒中量表(NIHSS)评分较干预前降低,药物组低于心理组;BDNF水平较干预前升高,药物组高于心理组(P<0.05)。两组干预8周后Barthel指数(BI)评分较干预前升高,药物组高于心理组(P<0.05);匹兹堡睡眠质量指数(PSQI)评分较干预前降低,药物组低于心理组(P<0.05)。经Fisher确切概率法检验,药物组不良反应发生率8.89%(4/45)与心理组4.44%(2/45)经比较无差异(P>0.05)。结论艾司西酞普兰可调节PSD患者神经功能,改善其生活及睡眠质量,调节抑郁情绪,有良好安全性。

Objective To investigate the effect of escitalopram on patients with poststroke depression(PSD)and its effect on brain-derived neurotrophic factor(BDNF).Methods A total of 90 patients with PSD admitted from February 2019 to September 2022 were selected as the research objects and divided into psychological group and drug group according to the intervention method,45 cases in each group.Both groups received basic symptomatic treatment,the psychological group received psychological intervention,and the drug group was treated with escitalopram.Depressive mood,neurological function,quality of life,quality of sleep and the occurrence of adverse reactions were compared between the two groups.Results After 8 weeks of intervention,the scores of Hamilton Depression Scale(HAMD)and National Institutes of Health Stroke Scale(NIHSS)in both groups were lower than before intervention,and the drug group was lower than the psychological group.The level of BDNF in drug group was higher than that in psychological group(P<0.05).After 8 weeks of intervention,Barthel index(BI)score in both groups was higher than that before intervention,and that in drug group was higher than that in psychological group.Pittsburgh Sleep Quality Index(PSQI)score was lower than that before intervention,and the drug group was lower than the psychological group(P<0.05).By Fisher's exact probability test,there was no difference in the incidence of adverse reactions between the drug group(8.89%)(4/45)and the psychological group(4.44%)(2/45)(P>0.05).Conclusion Escitalopram can regulate the neurological function of PSD patients,improve their quality of life and sleep,regulate depression,and has good safety.