鲁拉西酮联合草酸艾司西酞普兰治疗老年卒中后抑郁的疗效观察  

Therapeutic effect of combination therapy of lurasidone and escitalopram oxalate on post-stroke depression in elderly patients

作　　者：陈亮 刘立滢 涂献珠 陈光东 张秀澄 CHEN Liang;LIU Liying;TU Xianzhu;CHEN Guangdong;ZHANG Xiucheng(Department of Psychiatry,Wenzhou Seventh People's Hospital,Wenzhou 325000,China)

机构地区：[1]温州市第七人民医院精神科,325000

出　　处：《心电与循环》2024年第5期503-507,512,共6页Journal of Electrocardiology and Circulation

摘　　要：目的观察鲁拉西酮联合草酸艾司西酞普兰治疗老年卒中后抑郁的疗效。方法回顾性选取2020年5月至2021年6月温州市第七人民医院收治的92例老年卒中后抑郁患者为研究对象,采用鲁拉西酮联合草酸艾司西酞普兰治疗46例,为观察组;仅草酸艾司西酞普兰治疗46例,为对照组。观察并比较两组患者疗效、治疗期间不良反应以及治疗前与治疗6个月后事件相关电位参数[包括失匹配负波(MMN)和P300的潜伏期及波幅]、实验室指标[包括血清尿酸(UA)、睫状神经营养因子(CNTF)、脑源性神经营养因子(BDNF)水平]、神经功能[采用美国国立卫生研究院卒中量表(NIHSS)评价]、抑郁状况[采用17项汉密尔顿抑郁量表(HAMD-17)评价]等。结果观察组临床总有效率明显高于对照组(93.48%比78.26%,P=0.036)。治疗后,两组患者MMN潜伏期、P300潜伏期均明显缩短(均P<0.05),MMN波幅、P300波幅均明显增加(均P<0.05),血清UA、CNTF、BDNF水平均明显升高(均P<0.05),NIHSS、HAMD-17评分均明显降低(均P<0.05);且观察组上述指标较对照组变化均更明显(均P<0.05)。两组患者合计不良反应发生率比较,差异无统计学意义(10.87%比8.70%,P=0.726)。结论鲁拉西酮联合草酸艾司西酞普兰治疗老年卒中后抑郁的疗效较好,能改善事件相关电位、神经功能缺损以及抑郁状况,提高血清UA、CNTF、BDNF水平,且安全性较高。Objective To observe the efficacy of the combination of lurasidone and escitalopram oxalate in the treatment of post-stroke depression in elderly patients.Methods A retrospective study was conducted on 92 elderly patients with post-stroke depression admitted to Wenzhou Seventh People's Hospital from May 2020 to June 2021.Among them,46 patients were treated with combination therapy of lurasidone and escitalopram oxalate as observation group,another 46 cases were treated with only escitalopram oxalate as control group.The study observed and compared the efficacy of two groups of patients,as well as their adverse reactions during treatment,event-related potential parameters before and 6 months after treatment[including the latency and amplitude of mismatch negative waves(MMN)and P300)],laboratory indicators[including serum uric acid(UA),ciliary neurotrophic factor(CNTF),brain-derived neurotrophic factor(BDNF)levels)],neurological function[evaluated using the National Institutes of Health Stroke Scale(NIHSS)],and depression status[evaluated using the Hamilton Depression Scale-17(HAMD-17)].Results The total clinical effective rate of observation group was significantly higher than that of control group(93.48%vs.78.26%,P=0.036).After treatment,both groups of patients had significantly shortened the latency of MMN and P300(both P<0.05),significantly increased the amplitude of MMN and P300(both P<0.05),significantly increased serum UA,CNTF and BDNF levels(all P<0.05),and significantly decreased NIHSS and HAMD-17 scores(both P<0.05).The above indicators in observation group showed more significant changes compared to control group(all P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients(10.87%vs.8.70%,P=0.726).Conclusion The combination of lurasidone and escitalopram oxalate has a good therapeutic effect on post-stroke depression in elderly patients,which can improve event-related potentials,neurological deficits,and depression status,and

关 键 词：鲁拉西酮 草酸艾司西酞普兰 卒中 抑郁 睫状神经营养因子 脑源性神经营养因子 

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]