帕罗西汀对缺血性卒中不伴抑郁患者神经功能恢复的临床疗效观察  

Clinical Effect Observation of Paroxetine on the Neural Function Recovery in Ischemic Stroke Patients without Depression

作　　者：潘小玲[1] 程兴[1] 胡传琛[1] 王建伟[1] 邵慧军[1] 傅亚明 孔慧梅[1] 陈红芳[1] 

机构地区：[1]浙江大学金华医院神经内科,金华321000

出　　处：《中国卒中杂志》2017年第2期119-123,共5页Chinese Journal of Stroke

摘　　要：目的观察帕罗西汀对缺血性卒中且不伴抑郁的患者神经功能恢复方面的影响。方法选取急性缺血性卒中且不伴抑郁的住院患者共167例,采用随机数字表法分为治疗组及对照组,对照组入院48 h内缺血性卒中常规脑梗死二级预防及康复训练,治疗组在对照组基础上加用帕罗西汀(10 mg/d×1周,之后20 mg/d)治疗,治疗3个月,共观察6个月。对两组患者在入组时、治疗半个月、治疗3个月及入组6个月时分别进行Fugl Meyer运动量表(the Fugl Meyer Motor Scale,FMMS)、Montreal认知评估量表(the Montreal Cognitive Assessment,Mo CA)及汉密尔顿抑郁量表(the Hamilton Depression Scale,HAMD)检测,并进行组间比较。结果在治疗3个月及随访6个月时两组患者FMMS、Mo CA评分组间比较差异具有显著性(P<0.05),而治疗15 d时两组患者FMMS、Mo CA评分组间比较无明显差异;在随访6个月时两组患者HAMD评分组间比较,差异具有显著性(P<0.05),而治疗15 d及治疗3个月时两组患者HAMD评分组间比较无明显差异。结论在急性缺血性卒中不伴抑郁患者中早期应用帕罗西汀治疗能改善患者运动功能,并促进认知功能恢复,且能减少卒中后抑郁的发生。Objective To investigate the effects of paroxetine on neural function recovery in ischemic stroke patients without depression. Methods A total of 167 acute ischemic stroke hospitalized patients without depression were selected and divided into the treatment group and the control group randomly. All patients received the conventional secondary prevention and rehabilitation training of ischemic stroke, the treatment group patients were additionally treated with paroxetine （10 mg/d in the ifrst week, and then 20 mg/d） for 3 months, and observed for 6 months. The Fugl-Meyer Motor Scale （FMMS）, Montreal Cognitive Assessment （MoCA） and Hamilton Depression Scale （HAMD） were used at day 0, day 15, day 90 and day 180 （90 days after the treatment stopped） after the start of the study, then a comparison about the scores between the two groups were made. Results There were statistical differences in the FMMS and MoCA scores between the treatment and control group at day 90 and day 180 after the start of the study （P〈0.05）, whereas there were no statistical differences in the FMMS and MoCA scores between the two groups at day 15 （P〉0.05）. There were statistical differences in the HAMD scores between the two groups at day 180 afterthe start of the study （P〈0.05）, whereas there were no statistical differences in the HAMD scores between the two groups at day 15 and day 90. Conclusion Paroxetine could improve motor and cognitive function recovery in acute ischemic stroke patients without depression. Moreover, it would reduce the occurrence of depression after stroke.

关 键 词：缺血性卒中 帕罗西汀 神经功能恢复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]