舍曲林早期预防卒中后抑郁对急性脑梗死患者功能康复的影响  

Effects of sertraline in early prophylactic treatment on neurological rehabilitation in patients with acute cerebral infarction

作　　者：万其容[1] 胡亚荣[1] 刘浩[1] 李中明[1] 雷超[1] 

机构地区：[1]华中科技大学同济医学院附属梨园医院,湖北武汉430077

出　　处：《中国医院药学杂志》2015年第19期1768-1771,共4页Chinese Journal of Hospital Pharmacy

基　　金：湖北省自然科学基金(编号:2012FFB02430)

摘　　要：目的:观察在脑梗死患者急性期预防性给予抗抑郁药盐酸舍曲林片对卒中后抑郁(PSD)的发生率和神经功能康复、日常生活能力以及认知功能的影响。方法:将65例首发脑梗死患者随机分为对照组(n=32)和干预组(n=33)。干预组于入院72 h后每晚予以盐酸舍曲林片口服,对照组不给予抗抑郁药处理,治疗疗程为12周。在治疗前、治疗4周末、治疗12周末采用美国国立卫生院神经功能缺损评分量表(NIHSS)、改良Barthel指数量表(MBI)、汉密尔顿抑郁量表(HAMD)、蒙特利尔认知评估量表(MoCA)分别观察患者的神经功能缺损状态、日常生活能力、PSD发生率以及认知功能水平。结果:在治疗4周和12周末,干预组的NIHSS评分分别为(12.67±1.71)和(6.24±1.31),显著低于对照组;而干预组的MBI评分分别为(80.48±6.17)和(92.21±3.91)显著高于对照组的(76.09±4.89)和(85.37±6.71)。干预组在4周末和12周末的PSD发生率分别为18.2.%和12.1%,显著低于对照组的43.8%和37.5%。干预组的MoCA评分分别为(23.82±6.14)和(26.75±5.61),显著高于对照组的(21.75±4.92)和(23.65±3.89)。结论:在脑梗死急性期预防性给予舍曲林治疗,能显著降低卒中后抑郁的发生率,促进患者的神经功能康复,提高其日常生活能力以及认知功能水平。OBJECTIVE To observe whether prophylactic sertraline has any beneficial effects on neurological rehabilitation, activities of daily living, cognitive function and incidence of post-stroke depression （PSD） in patients with cerebral infarction of acute episode. METHODS A total of 65 patients with cerebral infarction of acute episode were randomly assigned to control group （n = 32）, intervention group （n = 33） and treated for 3 months. Patients received sertraline per day 72h after admission in intervention group, but no antidepressant in control group. Efficacy was assessed by National Institute of Health Stroke Scale （NIHSS）, modified Barthel index （MBI）, HAMD and Montreal cognitive assessment （MoCA） before and after 4 weeks and 12 weeks of treatment. RESULTS After 4 and 12 weeks of treatments, NIHSS scores of intervention group were 12. 67 ± 1.71 and 6. 24± 1.31, with significant improvement compared with control group. MBI scores and MoCA scores of intervention group increased more significantly than control group after 4 and 12 weeks of treatment. PSI：） incidences of intervention group were 18. 2.% and 12. 1%, respectively, significantly lower than 43. 8% and 37. 5 % in control group. CONCLUSION Our study comes to the conclusion that prophylactic sertraline treatment can more quickly and effectively reduce incidence of PSD, improve rehabilitation of neurological functions, promote capacity of daily life and cognitive functions in patients with cerebral infarction of acute episode.

关 键 词：脑梗死 卒中后抑郁 舍曲林 神经功能 认知功能 

分 类 号：R969[医药卫生—药理学]