丁苯酞序贯治疗对缺血性卒中后抑郁的预防作用观察  

Observation of prevention effect of butylphthalide sequential treatment for depression after ischemic stroke

作　　者：刘喜艳[1] 甄微 雷俊锋[1] 王红英[1] 牛娜 刘淑娟 崔秀卿 刘新蕊 李会敏 LIU Xiyan ZHEN Wei LEI Junfeng et al(General Department, Hebei Sixth People＇s Hospital ,Baoding （071000）, Hebei , China.)

机构地区：[1]河北省第六人民医院综合科,河北保定071000

出　　处：《癫痫与神经电生理学杂志》2017年第5期257-259,268,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：对神经功能缺损量表（NIHSS）评分在7～24分的急性缺血性脑卒中患者早期给予丁苯酞序贯治疗进行卒中后抑郁（PSD）的预防，观察治疗前后脑卒中患者的神经功能缺损情况、汉密尔顿-17量表（HAMD）评分及PSD发病率差异。方法：选取NIHSS评分7～24分的急性缺血性脑卒中患者60例为研究对象，随机分为两组。所有入组患者给予缺血性脑血管病的常规治疗，且两组均给予丁苯酞氯化钠注射液治疗14d，14d后，治疗组继续加服丁苯酞软胶囊作序贯治疗，总疗程8周。在治疗前及治疗后8周分别评价两组患者的NIHSS、HAMD评分，并比较两组间的差异及PSD的发病率，评价丁苯酞序贯治疗对缺血性脑卒中患者神经功能缺损、HAMD评分的影响及对PSD预防性治疗疗效。结果：治疗8周后，治疗组神经功能明显优于对照组（t=2．877，P=0．006），HAMD评分低于对照组（t=3．098，P=0．003），且PSD的发病率（7％）明显低于对照组（30％），两组间发病率比较差异有统计学意义（x2=4．672，P=0．031）。结论：针对缺血性脑卒中患者早期给予丁苯酞的序贯治疗，可有效促进卒中患者神经功能恢复，改善抑郁情绪，降低PSD的发病率，可在临床实践中考虑应用。Objective：To study the neurological function defect score （NIHSS） in 7 to 24 points in patients with acute ischemic stroke who received butylphthalide sequential therapy for prevention from post-stroke depression （PSD）,and observe the neurological function defect in patients with cerebral apo- plexy, Hamilton-17 rating scale （HAMD） and the incidence of PSD before and after treatment. Methods： 60 patients whose NIHSS score7~24 with acute ischemic stroke were randomly divided into two groups. All patients in the group were treated with the routine therapy of ischemic cerebrovascular disease and the treatment of 14d by the butylphthalide injection. The treatment group continued oral administration of dl- 3 butylphthalide for 8 weeks. The NIHSS and HAMD scores were evaluated in two groups before and af- ter treatment, and the differences between the two groups and the incidence of PSD were compared. The effect of phthalephthphthalein treatment on neurofunctional defects was evaluated, and HAMD scores in patients with ischemic stroke and the efficacy of PSD preventive therapy were surmarized. Results：After treatment for 8w, the treatment group was significantly better than the control group （t~ 2. 877, P= 0. 006）, and the HAMD score in the treatment was lower than that in the control group （t-----3. 098, P= 0. 003）. The incidence of PSD （7~） was significantly lower than that in the control group （30~）, and the difference between the two groups was statistically significant （^（^ =4. 672, P=0. 031）. Conclusion： Butylphthalide sequential therapy in early treatment of acute ischemic stroke can effectively promote theneural functional recovery, improve depression, reduce the incidence of PSD, worth popularizing in clini- cal application.

关 键 词：缺血性脑卒中 卒中后抑郁(PSD) 神经功能缺损 预防 

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