艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁的疗效及对海马脑源性神经营养因子-酪氨酸蛋白激酶受体B通路的影响  

Efficacy of Escitalopram combined with Fluoxetine in the Treatment of Elderly Patients with Post-stroke Depression and Its Effect on BDNF-TrKB Pathway in the Hippocampus

作　　者：侯静静 牛静 毕文超 张立静 刘宪勇 HOU Jing-Jing;NIU Jing;BI Wen-Chao;ZHANG Li-Jing;LIU Xian-Yong(Department of Pharmacy,Shandong Armed Police Corps Hospital,Jinan 250000,China)

机构地区：[1]武警山东省总队医院药剂科,济南250000

出　　处：《中国药物经济学》2023年第8期82-84,92,共4页China Journal of Pharmaceutical Economics

摘　　要：目的探讨艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁的疗效及对海马脑源性神经营养因子(BDNF)-酪氨酸蛋白激酶受体B(TrkB)通路的影响。方法选取2018年1月至2021年12月武警山东省总队医院收治的脑卒中后抑郁患者89例作为研究对象,按照治疗方法不同分为两组。对照组(n=44)采用氟西汀治疗,观察组(n=45)采用艾司西酞普兰联合氟西汀治疗。比较两组临床疗效,汉密尔顿抑郁量表(HAMD)、Barthel评分,血清BDNF、TrkB水平及成本-效果。结果观察组治疗有效率(91.11%)高于对照组(75.00%)(χ^(2)=4.121,P<0.05)。治疗后,观察组HAMD评分低于对照组,Barthel评分及血清BDNF、TrkB水平高于对照组(P<0.05)。观察组成本-效果低于对照组(P<0.05)。结论艾司西酞普兰联合氟西汀治疗老年脑卒中后抑郁疗效显著,能有效改善患者抑郁症状,提高生活自理能力,调控血清BDNF、TrkB水平,且经济性更佳。Objective To explore the efficacy of escitalopram combined with fluoxetine in the treatment of elderly patients with post-stroke depression and its effect on brain derived neurotrophic factor(BDNF)-tyrosine protein kinase receptor B(TrkB)pathway in the hippocampus.Methods A total of 89 patients with post-stroke depression admitted to Shandong Armed Police Corps Hospital from January 2018 to December 2021 were selected as the study objects and divided into two groups according to different treatment methods.Control group(n-44)was treated with fluoxetine,observation group(n=45)was treated with escitalopram combined with fluoxetine.The clinical efficacy,Hamilton Depression Scale(HAMD),Barthel score,serum BDNF,TrkB levels and cost-effectiveness of the two groups were compared.Results The effective rate of observation group(91.11%)was higher than that of control group(75.00%)(χ^(2)=4.121,P<0.05).Afer treatment,the HAMD score of the observation group was lower than that of the control group,the Barthel score and serum BDNF and TrkB levels were higher than those of the control group(P<0.05).The cost-effectiveness of the observation group was lower than that of the control group(P<0.05).Conclusion Escitalopram combined with Fluoxetine has a significant effect in the treatment of senile post-stroke depression,which can effectively improve the depressive symptoms of patients,improve their ability to take care of themselves,regulate the levels of serum BDNF and TrkB,and is more economical.

关 键 词：脑卒中后抑郁 老年人 艾司西酞普兰 氟西汀 脑源性神经营养因子-酪氨酸蛋白激酶受体B通路 成本-效果 

分 类 号：R749.7[医药卫生—神经病学与精神病学] R971[医药卫生—临床医学]