草酸艾司西酞普兰联合度洛西汀治疗脑卒中后抑郁的临床疗效及对患者血清RBP4、5-HT的影响  

Clinical efficacy of escitalopram oxalate combined with duloxetine in the treatment of post-stroke depression and its influence on patients’serum RBP4 and 5-HT

作　　者：李世兴 LI Shi-xing(Department of Psychiatry,Siping Ji'ao Brain Hospital,Siping 136000,China)

机构地区：[1]四平吉奥脑病医院精神科,136000

出　　处：《中国实用医药》2022年第26期36-39,共4页China Practical Medicine

摘　　要：目的探讨草酸艾司西酞普兰联合度洛西汀治疗脑卒中后抑郁的临床疗效及对患者血清视黄醇结合蛋白4(RBP4)、5-羟色胺(5-HT)的影响。方法192例脑卒中后抑郁患者,采用随机数字表法分为对照组和观察组,每组96例。对照组给予度洛西汀口服治疗,观察组在对照组基础上给予草酸艾司西酞普兰口服治疗。比较两组临床疗效、不良反应发生情况以及治疗前后汉密尔顿抑郁量表(HAMD)评分、美国国立卫生研究院卒中量表(NIHSS)评分、血清RBP4水平、5-HT水平。结果观察组治疗总有效率为93.75%,高于对照组的83.33%,差异具有统计学意义(P<0.05)。治疗8周后,两组HAMD、NIHSS评分均较治疗前降低,且观察组患者HAMD评分(9.08±3.29)分、NIHSS评分(10.53±3.14)分均低于对照组的(12.23±3.52)、(14.12±3.66)分,差异均具有统计学意义(P<0.05)。治疗8周后,两组血清RBP4水平较治疗前降低,5-HT水平较治疗前升高,且观察组RBP4(22.13±3.58)mg/L低于对照组的(28.07±3.76)mg/L,5-HT(235.53±28.62)μg/L高于对照组的(208.36±25.59)μg/L,差异均具有统计学意义(P<0.05)。观察组不良反应发生率11.46%与对照组的12.50%比较,差异无统计学意义(P>0.05)。结论草酸艾司西酞普兰联合度洛西汀治疗脑卒中后抑郁具有良好的抗抑郁效果,可调节血清RBP4、5-HT水平,改善神经功能,且不良反应发生率低、毒副作用小,值得进一步推广应用。Objective To discuss the clinical efficacy of escitalopram oxalate combined with duloxetine in the treatment of post-stroke depression and its influence on patients’serum retinol-binding protein 4(RBP4)and 5-hydroxytryptamine(5-HT).Methods A total of 192 patients with post-stroke depression were divided into a control group and an observation group according to random numerical table,with 96 cases in each group.The control group was treated with oral duloxetine,and the observation group was treated with oral escitalopram oxalate on the basis of the control group.Both groups were compared in terms of clinical efficacy,the occurrence of adverse reactions and the Hamilton Rating Scale of Depression(HAMD)score,National Institutes of Health Stroke Scale(NIHSS)score,serum RBP4 level,5-HT level before and after treatment.Results The total effective rate of treatment in the observation group was 93.75%,which was higher than 83.33% in the control group,and the differences were all statistically significant(P<0.05).After 8 weeks of treatment,the HAMD and NIHSS scores in both groups were lower than those before treatment in this group;the HAMD score(9.08±3.29)points and NIHSS score(10.53±3.14)points in the observation group were lower than(12.23±3.52)and(14.12±3.66)points in the control group;the differences were all statistically significant(P<0.05).After 8 weeks of treatment,the serum RBP4 level in both groups was lower than that before treatment in this group,and the 5-HT level was higher than that before treatment in this group;in the observation group,the RBP4(22.13±3.58)mg/L was lower than(28.07±3.76)mg/L in the control group,and the 5-HT(235.53±28.62)μg/L was higher than(208.36±25.59)μg/L in the control group;the differences were all statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 11.46%,and the difference was not statistically significant compared with 12.50% in the control group(P>0.05).Conclusion Escitalopram oxalate combined with duloxetine for post-st

关 键 词：脑卒中后抑郁 草酸艾司西酞普兰 度洛西汀 临床疗效 视黄醇结合蛋白4 5-羟色胺 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]