脑卒中后抑郁西医治疗的研究进展  

Research Progress of Western Medicine in Treatment of Patients with Post-stroke Depression

作　　者：沈蓉[1] 周华[1] 赵中[1] SHENG Rong;ZHOU Hua;ZHAO Zhong(Department of Neurology,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院神经内科,江苏苏州215000

出　　处：《医学综述》2021年第24期4883-4887,共5页Medical Recapitulate

基　　金：第五批姑苏卫生人才培养项目(GSWS2019058)。

摘　　要：脑卒中后抑郁(PSD)因具有高发病率、高复发率、高致残率等特点,需要尽早治疗。西医治疗是PSD的有效治疗方式。西医治疗PSD的方式主要包括药物治疗(三环类抗抑郁药、四环类抗抑郁药、单胺氧化酶抑制剂、选择性5-羟色胺和去甲肾上腺素再摄取双重抑制剂、选择性5-羟色胺再摄取抑制剂、他汀类药物)、心理治疗以及其他治疗(电惊厥、高压氧)等,均具有一定优势。但采取不同西医治疗方案的PSD患者临床疗效、安全性并不相同,因此,具体选取哪种治疗方案可使患者最大程度获益、减少不良反应是目前亟待解决的问题。Post-stroke depression(PSD)is characterized by high incidence,high recurrence and high disability rate,therefore,early treatment is necessary.Western medicine is an effective treatment for PSD.The methods of western medicine in treating PSD mainly include medication(tricyclic antidepressants,tetracyclic antidepressants,monoamine oxidase inhibitor,dual selective reuptake inhibitors of 5-hydroxytryptamine and norepinephrine,5-hydroxytryptamine selective reuptake inhibitors,statins),psychotherapy and other therapies(electroconvulsive and hyperbaric oxygen),etc.,which have certain advantages.However,the clinical efficacy and safety of different western medicine treatment schemes for the PSD patients are not the same,therefore,how to select the specific treatment scheme to maximize the benefits of the patients and reduce adverse reactions is an urgent problem to be solved.

关 键 词：脑卒中后抑郁 选择性5-羟色胺 三环类抗抑郁药 单胺氧化酶抑制剂 四环类抗抑郁药物 

分 类 号：R749.1[医药卫生—神经病学与精神病学]