艾司西酞普兰联合高频重复经颅磁刺激对缺血性脑卒中后抑郁及神经功能恢复的影响

Effect of escitalopram combined with high frequency repetitive transcranial magnetic stimulation on post-ischemic stroke depression and neurological function recovery

目的:探讨艾司西酞普兰联合高频重复经颅磁刺激对缺血性脑卒中后抑郁(PSD)及神经功能恢复的影响。方法:将符合标准的96例PSD患者随机分为研究组(48例)和对照组(48例),两组患者均在缺血性脑卒中常规治疗基础上,研究组采用高频(10Hz)rTMS联合艾司西酞普兰治疗,对照组接受rTMS伪刺激联合艾司西酞普兰治疗,共4周。于治疗前、治疗2周后及4周后应用汉密尔顿抑郁量表(HAMD)评定临床疗效,应用美国国立卫生研究院卒中量表(NIHSS)及Bathel指数(BI)评定神经功能。结果:经2周及4周治疗后,研究组有效率均显著高于对照组,差异有统计学意义(χ~2=8.224,8.000;P<0.01);两组在治疗2周及4周时HAMD分值较治疗前均明显降低,与对照组相比,研究组HAMD分值降低较显著(t=-3.484,-5.168;P<0.001);与治疗前相比,两组NIHSS分值均降低,BI分值明显升高,研究组NIHSS的减分值和BI的升高值显著高于对照组(t=2.228,P<0.05;t=2.815,P<0.01;t=2.927,P<0.01;t=5.273,P<0.001)。结论:艾司西酞普兰联合高频rTMS对PSD患者抑郁情绪缓解及神经功能恢复疗效显著,明显改善脑卒中患者预后。

Objective:To explore the effects of alcitalopram combined with high frequency transcranial magnetic stimulation on post-ischemic stroke depression and neurological recovery.Methods:A total of 96 patients of PSD were randomly divided into research group(48 cases)and control group(48 cases),two groups of patients were given ischemic stroke based on regular treatment,the study group with high frequency(10 Hz)joint escitalopram citalopram rTMS treatment,control group accepted rTMS pseudo stimulate joint escitalopram citalopram treatment,the treatment last for a total of 4 weeks.Before treatment,treatment after 2 weeks and 4 weeks Hamilton depression rating scale(HAMD)were used to assess the clinical curative effect,the United States national institutes of health stroke scale(NIHSS)scores and Bathel index(BI)were used to evaluate nerve function.Results:After 2 weeks and 4 weeks of treatment,the effective rates of the group were significantly higher than those of the control group,and the difference was statistically significant(χ~2=8.224,8.000;P<0.01);In both groups,the HAMD score was significantly lower than before treatment in 2 weeks and 4 weeks,compared with the control group,and the HAMD score decreased significantly(t=3.484,5.168;P<0.001).Compared with before treatment,the NIHSS scores of both groups were reduced,and the BI score was significantly increased,and the decrease of NIHSS in the study group and the increase of BI were significantly higher than those of the control group(t=2.228,2.815,2.927,5.273;P<0.001).Conclusion:Escitalopram combined with high frequency rTMS has significant effect on depression and neurofunction recovery in PSD patients,significantly improve the prognosis of patients with stroke.