齐拉西酮联合度洛西汀治疗对老年脑卒中后抑郁患者神经递质5-HT、ET水平的影响

Effect of Ziprasidone Combined with Duloxetine on the Levels of 5-HT and ET in Elderly Patients with Post-stroke Depression

目的:探讨齐拉西酮联合度洛西汀治疗对老年脑卒中后抑郁(PSD)患者神经递质5-羟色胺(5-HT)、内皮素(ET)水平的影响。方法:选取2021年11月—2023年1月驻马店市第二人民医院收治的180例老年PSD患者作为研究对象,按照随机数表法将其分为对照组(n=90)和观察组(n=90)。对照组患者给予度洛西汀治疗,观察组患者给予度洛西汀联合齐拉西酮治疗,观察两组患者临床疗效、神经递质水平、A型行为以及副反应发生情况。结果:观察组患者治疗总有效率(92.22%)高于对照组(81.11%)(χ^(2)=4.808,P<0.05);治疗后,观察组患者ET、5-HT水平较对照组水平高,差异有统计学意义(t=29.698、8.001,P<0.05);两组患者A型行为量表(TABP)时间紧迫感(TH)、敌意竞争(CH)维度及总分均较治疗前降低,且观察组得分较对照组低,差异有统计学意义(t=2.233、3.220、2.074,P<0.05);两组患者副反应量表(TESS)得分比较,差异无统计学意义(t=0.537,P>0.05)。结论:齐拉西酮联合度洛西汀治疗老年PSD患者可以有效提高临床治疗总有效率,提升神经递质水平,改善A型行为,且不会增加药物副反应的发生。

Objective:To investigate the effects of ziprasidone combined with duloxetine on the levels of neurotransmitters 5-hydroxytryptamine(5-HT)and endothelin(ET)in elderly patients with post-stroke depression(PSD).Methods:A total of 180 elderly patients with PSD in the hospital from November 2021 to January 2023 were selected as research objects.They were divided into control group(n=90)and observation group(n=90)according to random number table method.The control group was given duloxetine treatment,and the observation group was given duloxetine+Ziprasidone treatment.The clinical efficacy,neurotransmitter level,type A behavior and occurrence of side effects of the two groups were observed.Results:The total effective rate of observation group(92.22%)was higher than 81.11%of control group(χ^(2)=4.808,P<0.05).After treatment,the levels of ET and 5-HT in observation group were higher than those in control group(t=29.698,8.001;P<0.05).The dimension of time urgency(TH),hostile competition(CH)and total score of Type A behavior scale(TABP)in both groups were lower than before treatment,and the score of observation group was lower than control group(t=2.233,3.220,2.074;P<0.05).There was no significant difference in TESS scores between the two groups(t=0.537,P>0.05).Conclusion:Ziprasidone combined with duloxetine in the treatment of elderly PSD can effectively improve the total effective rate of clinical treatment,enhance the level of neurotransmitter,improve the type A behavior,and do not increase the occurrence of drug side reactions.