氟西汀治疗脑卒中后抑郁的疗效及对认知功能的影响  

Efficacy of fluoxetine in the treatment of post-stroke depression and its influence on cognitive function

作　　者：杨卫华[1] 董介正[1] 李秀荣[1] 

机构地区：[1]杭州市第七人民医院8病区,浙江杭州310013

出　　处：《中国现代医生》2016年第34期24-26,30,共4页China Modern Doctor

基　　金：浙江省中医药科学研究基金计划项目(2012ZB134)

摘　　要：目的 观察氟西汀治疗脑卒中后抑郁的疗效及对认知功能的影响。方法 选取2014年4月~2016年4月在我院就诊的120例脑卒中后抑郁患者,随机分为两组,其中60例为研究组,余60例为对照组,两组均按照脑卒中常规方法治疗,研究组患者在上述神经内科常规治疗的基础上予氟西汀20 mg,每天1次,口服,疗程6周。观察比较两组患者治疗后的临床疗效、两组治疗前后的MoCA评分、MMSE各项评分。结果 研究组治疗后的总有效率为96.7%,对照组治疗后的总有效率为78.3%,两组比较差异有统计学意义（P〈0.05）。研究组患者治疗后的MoCA评分（19.15±3.22）分,分别高于治疗前及对照组,组间比较差异有统计学意义（P〈0.05）。研究组患者治疗后的MMSE各项包括记忆、注意和计算、定向力、语言能力、概念形成评分分别为（4.4±2.2）、（2.6±1.4）、（2.8±1.2）、（2.9±1.1）、（2.7±1.2）,分别明显高于对照组（2.8±1.4）、（2.1±1.3）、（2.3±1.4）、（2.1±1.3）、（1.8±0.7）,组间比较差异有统计学意义（P〈0.05）。结论 氟西汀治疗脑卒中抑郁疗效确切,对脑卒中患者的抑郁情绪和认知缺陷有较好的改善作用,结合脑卒中神经内科常规治疗对提高疾病的治疗效果、改善患者的预后和促进疾病的康复具有重要作用,值得推广和应用。Objective To observe and analyze the efficacy of fluoxetine in the treatment of post-stroke depression and its influence on cognitive function. Methods 120 patients with post-stroke depression in our hospital from April 2014 to April 2016 were enrolled and randomly divided into two groups including 60 cases in the observation group and 60 cases in the control group.The two groups were treated the conventional method, and the patients in the study group were given fluoxetine 20 mg once a day for 6 weeks on the basis of routine treatment of neurology.The clinical efficacy of patients in two groups were compared after treatment,the MoCA score and MMSE score of the two groups before and after treatment were observed and analyzed. Results The total effective rates in the study group and in the control group were 96.7% and 78.3%, respectively, and the difference was statistically significant（P〈0.05）. The MoCA score of the study group（19.15±3.22） after treatment was significantly higher than before and than that of the control group（P〈0.05）. The scores of the MMSE items including memory, attention and calculation, orientation,language competence,concept formation in the study group were（4.4±2.2）,（2.6±1.4）,（2.8±1.2）,（2.9±1.1）and（2.7±1.2）, respectively, significantly higher than those of the control group（2.8±1.4）,（2.1±1.3）,（2.3±1.4）,（2.1±1.3）, and（1.8±0.7）. There was significant difference between the two groups（P〈0.05）. Conclusion Fluoxetine is effective in the treatment of post-stroke depression, with a good effect on depressive mood and cognitive deficits of stroke patients. Fluoxetine combined with conventional neurological in treatment of stroke can improve the treatment effect and promot the rehabilitation of the disease, which is worthy of promotion and application.

关 键 词：脑卒中后抑郁 氟西汀 认知功能 MoCA评分 

分 类 号：R743.3[医药卫生—神经病学与精神病学]