摘要
目的探究缺血性脑卒中后抑郁(PSD)患者应用丁苯酞联合艾司西酞普兰对神经功能及焦虑抑郁情绪的影响。方法选取辽健集团本钢总医院神经内科2018-08-01-2020-10-01有完整随访记录的缺血性PSD住院患者107例。以随机数字表法分为2组,均给予常规治疗,其中对照组53例给予口服艾司西酞普兰(10 mg/次,1次/d),观察组在此基础上联用丁苯酞(0.4 g/次,3次/d)治疗,对比治疗后2组患者神经功能:美国国立卫生研究院卒中量表(NIHSS)分数0~42分、简易智能量表(MMSE)分数0~30分;焦虑抑郁情绪:汉密尔顿焦虑量表(HAMA)分数≥14分为焦虑、汉密尔顿抑郁量表(HAMD)分数≥17分为抑郁;神经递质水平:采用高效液相色谱法检测天冬氨酸(ASP)、5-羟色胺(5-HT)、谷氨酸(Glu)及多巴胺(DA)水平,采用SPSS 22.0对数据进行统计学分析。结果治疗后观察组NIHSS水平(5.47±1.61)分较对照组(7.28±3.20)分低,差异有统计学意义(t=3.685,P<0.001),观察组MMSE水平(24.51±4.08)分较对照组(16.52±5.63)分高,差异有统计学意义,t=8.393,P<0.001;观察组HAMA水平为(12.42±2.40)分较对照组(17.73±4.62)分低,差异有统计学意义,t=7.440,P<0.001。观察组5-HT水平(326.83±43.22)μg/L高于对照组(259.84±41.15)μg/L,差异有统计学意义,t=8.209,P<0.001;DA水平(190.18±31.55)μg/L高于对照组(152.83±26.74)μg/L,差异有统计学意义,t=6.600,P<0.001;ASP水平(1.23±0.21)mmol/L低于对照组(1.87±0.72)mmol/L,差异有统计学意义,t=6.217,P<0.001;Glu水平(13.52±2.08)mmol/L低于对照组(18.35±4.46)mmol/L,差异有统计学意义,t=7.157,P<0.001。结论丁苯酞联合艾司西酞普兰应用PSD患者中可有效调节神经递质水平,延缓神经功能损伤,减轻抑郁焦虑情绪。
Objective To investigate the effect of butylphthalide combined with escitalopram on neurological function and anxiety and depression in patients with ischemic post-stroke depression(PSD).Methods A total of 107 hospitalized patients with depression after ischemic stroke with complete follow-up records were selected in the Department of Neurology,Benxi Iron and Steel General Hospital of Liaojian Group from August 1,2018 to October 1,2020.The patients were randomly divided into two groups and given routine treatment.The control group was given oral escitalopram(10 mg/time,once a day),and the observation group was treated with butylphthalein(0.4 g/time,3 times a day)on the basis of control group.The neurological function of patients in the two groups after treatment was compared,according to National Institutes of Health Stroke Scale(NIHSS)score 0-42 and Simple Intelligence Scale(MMSE)score 0-30;Anxiety and depression were assessed.Those whose Hamilton Anxiety Scale(HAMA)score≥14 was classified as anxiety,and whose Hamilton Depression Scale(HAMD)score≥17 was classified as depression;As for neurotransmitter levels,Aspartic acid(ASP),5-hydroxytryptamine(5-HT),glutamate(Glu)and dopamine(DA)levels were detected by HPLC,and data were statistically analyzed by SPSS 22.0.Results After treatment,the national Institutes of Health Stroke Scale(NIHSS)score of the observation group(5.47±1.61)was lower than that of the control group(7.28±3.20),the difference was statistically significant(t=3.685,P<0.001).The MMSE level of the observation group(24.51±4.08)was higher than that of the control group(16.52±5.63),and the difference was statistically significant(t=8.393,P<0.001).The HAMA level of the observation group was(12.42±2.40)lower than that of the control group(17.73±4.62),and the difference was statistically significant,t=7.440,P<0.001.The level of 5-HT in observation group(326.83±43.22)μg/L was higher than that in control group(259.84±41.15)μg/L,and the difference was statistically significant(t=8.209,P<0.001).DA level(190.18±31.55)μg/L was higher than that of control group(152.83±26.74)μg/L,and the difference was statistically significant(t=6.600,P<0.001).The level of ASP(1.23±0.21)mmol/L was lower than that of control group(1.87±0.72)mmol/L,and the difference was statistically significant(t=6.217,P<0.001).The level of Glu(13.52±2.08)mmol/L was lower than that of the control group(18.35±4.46)mmol/L,the difference was statistically significant(t=7.157,P<0.001).Conclusion Butylphthalide combined with escitalopram can effectively regulate the level of neurotransmitters,delay the neurological impairment and relieve depression and anxiety in PSD patients.
作者
王丽荣
张玉涛
王文凯
WANG Li-rong;ZHANG Yu-tao;WANG Wen-kai(Department of Neurology,Benxi Iron and Steel General Hospital,Liaojian Group,Benxi 117000,China;Department of Internal Medicine,Linfen Central Hospital,Linfen 041600,China)
出处
《社区医学杂志》
CAS
2022年第10期547-551,共5页
Journal Of Community Medicine
作者简介
通信作者:王丽荣,女,山西临汾人,副主任医师,主要从事脑血管病溶栓、神经系统脱髓鞘病、周围神经病及头迷等的临床研究工作。E-mail:she15900182@163.com
