氟西汀对脑卒中后非抑郁患者神经功能康复的影响

Effects of fluoxetine on neurofunctional recovery of nondepressed patients after stroke

目的:了解氟西汀对脑卒中后非抑郁患者神经功能康复的影响。方法:60例脑卒中后非抑郁患者按入院时间分为治疗组(30例)对照组(30例),除脑卒中后常规的药物治疗和康复训练指导外,治疗组加用氟西汀20mg/d,分别在治疗前,治疗后30,60d用汉密抑郁量表(HAMD),汉密顿焦虑量表(HAMA),MESS,ADL评价患者的情绪和神经功能。结果:发现治疗组在30d时ADL改善与对照组在统计学上有显著差异(P<0.05),在60d时MESSS和ADL的改善与对照组在统计学上有显著性差异(P<0.05),而两组在治疗前、治疗30,60d,HAMD、HAMA评分均无显著性差异(P>0.05)。结论:氟西汀能够改善卒中后非抑郁患者的神经功能,其机制的确与抗抑郁作用无关,可能是氟西汀能提高突触间隙5-羟色胺(5-HT)的浓度,促进5-HT突触的传递作用,来改善神经运动功能,促进脑损伤后神经功能的恢复。

AIM:To comprehend the effect of fluoxet ine on post-stroke nondepressed patients' neurological function rehabilitation.METHODS:Sixty post-stroke nondepressed patients were divided into two groups:treatment group and control group.Treatment group used fluoxetine 20mg /d besides routine medicine treatment and rehabilitation training after stroke.HAMD ,HAM A ,MESSS and ADL were used to evaluate th e emotion or neurological function of patients before the treatment,on the thirtieth day and the sixtieth day of the treatment.RESULTS:There were significant difference o n the thirtieth day of treatment in ADL between the tr eatment group and control group(P<0.05),and also on sixtieth day of treatmen t in MESS and ADL(P<0.05.However,there were no signifi cant difference before,on the thirtieth and on the sixtieth day of treatment i n HAMD,HAMA(P>0.05).CON-CLUSION:Fluoxetine can improve the neurolog ical function of post-stroke nondepressed patients.The possibl e mechanism is that fluoxetine can im-prove 5-HT' s concentration in synaptic cleft an d promote 5-HT' s transmis-sion in synapse to advance neurologi cal motor function and neurological function rehabilitation after cere bral impairment.This mechanism has no relationship with its function of an tidepressant.