氟西汀对卒中后抑郁患者外周型苯二氮卓受体及神经功能缺损影响研究  

Effects of fluoxetine on peripheral benzodiazepine receptors and neurologic deficits in patients with post-stroke depression

作　　者：刁晓君[1] 陈春富[1] 李聪聪[1] 陈嫄[1] 肖萧[1] 

机构地区：[1]山东大学附属省立医院神经内科,济南250021

出　　处：《中国实用内科杂志》2015年第9期772-775,共4页Chinese Journal of Practical Internal Medicine

基　　金：山东省自然科学基金重点项目(Z2007C03)

摘　　要：目的观察氟西汀对卒中后抑郁(PSD)患者外周血外周型苯二氮卓受体(PBRs)及神经功能的影响。方法收集2005年12月至2008年3月山东大学附属省立医院神经内科收治的首次发病的脑梗死后抑郁患者86例,将其随机分为氟西汀组和对照组。氟西汀组给予氟西汀20 mg/d,连续服药4周;对照组给予茴拉西坦胶囊100 mg/d。采用改良的斯堪的那维亚神经功能缺损评分量表(SSS)评价神经功能。提取外周血血小板膜,应用放射配基[3H]PK11195结合试验测定PBRs特异结合活性。结果治疗前两组组间[3H]PK11195结合活性差异无统计学意义(t=1.089,P=0.279)。治疗后氟西汀组PBRs结合活性显著高于对照组(t=14.797,P<0.001),Hamilton抑郁量表(HAMD)评分(t=6.369,P<0.001)、SSS评分(t=2.897,P=0.005)显著低于对照组。患者血小板膜PBRs结合活性与HAMD评分(r=-0.303,P=0.006)及SSS评分均具有显著相关性(r=-0.255,P=0.019)。结论氟西汀能够增加PSD患者血小板膜PBRs结合活性,促进神经功能恢复。Objective To evaluate the effects of fluoxetine on peripheral benzodiazepine receptors （PBRs） and neurologic deficits in patients with post-stroke depression （PSD）. Methods Eighty-six cases with PSD were randomized into fluoxetine group and control group, received fluoxetine （20 rag/d） and aniracetam capsules （100 nag/d） respectively for four weeks. The scores of the modified Edinburgh-Scandinavia stroke scale （SSS） were measured. Platelet membrane in venous blood was prepared. Binding assay of the radioactive PBRs antagonist [3H]PK11195 to platelet membrane was performed. Results Before treatment, no significant difference about PBRs binding was found between the two groups （t = 1.089, P = 0.279）. After treatment, PBRs binding increased （t = 14.797, P= 0.001）, while the scores of both Hamilton Depression Rating Scale （t = 6.369, P = 0.001） and SSS （t = 2.897, P = 0.005） decreased significantly in the fluoxetine group as compared with those in the control group. Negative correlation was found between platelet membrane PBRs binding and HAMD scores （r = -0.303, P = 0.006） as well as SSS scores （r = -0.255, P = 0.019）. Conclusions Fluoxetine can increase PBRs binding in platelet membrane and improve neurological function in PSD patients.

关 键 词：卒中后抑郁 脑梗死 外周型苯二氮卓受体 血小板 氟西汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]