艾司西肽普兰联合米氮平对脑卒中后抑郁患者神经功能及5-羟色胺、雷帕霉素靶蛋白水平的影响  

Effect of Escitalopram combined with Mirtazapine on neurological function and levels of 5-hydroxytryptamine and mammalian target of Rapamycin in patients with post-stroke depression

作　　者：李霞 LI Xia(Department of Internal Neurology,Shangrao Municipal Hospital,Jiangxi Province,Shangrao334000,China)

机构地区：[1]江西省上饶市立医院神经内科,江西上饶334000

出　　处：《中国当代医药》2021年第36期143-145,149,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20202014)。

摘　　要：目的探讨艾司西肽普兰联合米氮平对脑卒中后抑郁患者神经功能及5-羟色胺(5-HT)、雷帕霉素靶蛋白(mTOR)水平的影响。方法选取2019年7月至2020年12月上饶市立医院收治的62例脑卒中后抑郁患者作为研究对象,采用随机数字表法将其分为对照组(31例)和试验组(31例)。对照组采用米氮平片治疗,试验组在对照组基础上联合草酸艾司西肽普兰片治疗,两组均连续治疗42 d。比较两组患者治疗前后的日常生活能力量表(ADL)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿抑郁量表(HAMD)、美国国立卫生研究院卒中量表(NIHSS)评分及血清5-HT、mTOR水平。结果治疗前,两组患者的PSQI、ADL、NIHSS、HAMD评分、血清mTOR与5-HT水平比较,差异均无统计学意义(P>0.05);两组患者治疗后的PSQI、NIHSS、HAMD评分均低于治疗前,且试验组患者治疗后的PSQI、NIHSS、HAMD评分低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的ADL评分、血清mTOR、5-HT水平均高于治疗前,且试验组患者治疗后的ADL评分、血清mTOR、5-HT水平均高于对照组,差异有统计学意义(P<0.05)。结论艾司西肽普兰联合米氮平可改善脑卒中后抑郁患者的日常生活能力,提升睡眠质量,同时降低抑郁程度,改善神经功能,提升血清5-HT、mTOR水平,改善临床症状,值得临床推广应用。Objective To investigate the effect of Escitalopram combined with Mirtazapine on neurological function and levels of 5-hydroxytryptamine(5-HT)and mammalian target of Rapamycin(mTOR)in patients with post-stroke depression.Methods A total of 62 patients with post-stroke depression admitted to Shangrao Municipal Hospital from July 2019 to December 2020 were selected as the study subjects,and divided into control group(31 cases)and experimental group(31 cases)by random number table method.The control group was treated with Mirtazapine Tablets,and the experimental group was treated with Escitalopram Oxalate Tablets on the basis of the control group.Both groups were treated for 42 consecutive days.The ability of daily living scale(ADL),Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD),National Institutes of Health stroke scale(NIHSS)scores and serum 5-HT,mTOR levels were compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in PSQI,ADL,NIHSS,HAMD scores,serum mTOR and 5-HT levels between the two groups(P>0.05).After treatment,PSQI,NIHSS and HAMD scores in the two groups were lower than those before,and PSQI,NIHSS and HAMD scores in experimental group were lower than those in the control group,with statistically significant differences(P<0.05).The ADL score,serum mTOR and 5-HT levels in the two groups after treatment were higher than those before,and the ADL score,serum mTOR and 5-HT levels in experimental group were higher than those in the control group after treatment,the differences were statistically significant(P<0.05).Conclusion Escitalopram combined with Mirtazapine can improve the daily life ability,sleep quality,depression,nerve function,serum 5-HT,mTOR levels,and improve clinical symptoms,which is worthy of clinical application.

关 键 词：脑卒中后抑郁 艾司西肽普 米氮平 神经功能 5-羟色胺 雷帕霉素靶蛋白 

分 类 号：R743.32[医药卫生—神经病学与精神病学]