叶酸及维生素B_(12)联合西酞普兰对卒中后抑郁高血浆同型半胱氨酸水平患者的疗效  

Efficacy of folic acid and vitamin B_(12) combined with citalopram in the treatment of patients with post-stroke depression and hyperhomocysteinemia

作　　者：胡锦全[1] 李贞艳[1] 袁江[1] 王云甫[1] 

机构地区：[1]湖北医药学院附属太和医院神经内科,湖北十堰442000

出　　处：《现代医学》2015年第4期450-452,共3页Modern Medical Journal

摘　　要：目的:观察叶酸、维生素B12联合西酞普兰对卒中后抑郁高血浆同型半胱氨酸(Hcy)水平患者的治疗效果。方法:90例卒中后抑郁患者分为A、B两组各45例,均予缺血性脑卒中常规治疗,A组予西酞普兰片20 mg·d-1口服,B组在口服西酞普兰基础上加用叶酸5 mg·d-1及维生素B120.5 mg·d-1口服。检测患者治疗前及治疗12周后血浆Hcy水平,采用汉密尔顿抑郁量表(HAMD)评估患者的抑郁状况,采用临床神经功能缺损程度评分标准(CSS)评价患者神经功能状况。结果:治疗12周后,A组患者血浆Hcy水平无明显变化(P>0.05),B组患者血浆Hcy水平明显下降,两组患者HAMD及CSS评分均较治疗前下降,B组患者的HAMD及CSS评分显著低于A组(P<0.05)。结论:叶酸、维生素B12联合西酞普兰治疗卒中后抑郁高血浆Hcy水平者能够显著降低患者血浆Hcy水平,改善抑郁状况,促进神经功能的恢复,疗效优于单用西酞普兰。Objective： To observe the therapeutic effect of folic acid and vitamin B12 combined with citalopram for post-stroke depression with hyperhomocysteinemia. Methods： Ninety cases of patients with post-stroke depression were divided into two groups （group A and B） （n = 45 ）. Both group A and B were given the conventional treatment of ischemic. Group A received citalopram 20 mg·d^-1, group B received folic acid 0. 4 mg ·d^-1and vitamin B12 0. 5 mg ·d^-1 combined with citalopram. Plasma Hcy were measured before treatment and at the end of 12 weeks of treatment, depression of patients were evaluated with Hamilton Depression Scale （ HAMD）, clinic nerve function defect score （CSS） was assessed for the patients＇ neurological function. Results：Mter 12 weeks, the Hcy level in group A did not significantly changed（P 〉 0.05 ）, while it significantly decreased in group B; the score of HAMD and CSS decreased both in group A and B. When compared with group A, it was significantly lower in group B （P 〈 0. 05）. Conclusion：Folic acid and vitamin B12 combined with citalopram can decrease the Hcy level, improve the symptom of depress and promote the neurological function recovery in the treatment of post-stroke depression, thus it is better than citalopram alone.

关 键 词：叶酸 维生素B12 卒中后抑郁 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]