艾地苯醌联合舍曲林治疗老年脑卒中后抑郁的疗效及对认知功能和氧化应激的影响  

To investigate the efficacy of idebenone combined with sertraline in the treatment of elderly patientswith post-stroke depression, and its effect on cognitive function and oxidative stress

作　　者：潘飞[1] 许彤[2] 张景丹[3] 赵峥[1] 李亚迪 徐亚南[5] 徐亚辉[6] PAN Fei;XU Tong;ZHANG Jingdan;ZHAO Zheng;LI Yadi;XU Yanan;XU Yahui(Fourth Department of Psychiatry,Second Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453000,China;不详)

机构地区：[1]新乡医学院第二附属医院精神四科,河南新乡453000 [2]新乡医学院第二附属医院心境障碍二科 [3]新乡医学院第二附属医院早期干预二科 [4]新乡医学院第二附属医院儿童少年精神科 [5]新乡医学院第二附属医院老年精神科 [6]新乡医学院第二附属医院睡眠科

出　　处：《中华全科医学》2025年第2期223-226,共4页Chinese Journal of General Practice

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190481)。

摘　　要：目的 探讨老年脑卒中后抑郁(PSD)患者采用艾地苯醌联合舍曲林治疗的效果,并分析其对认知功能及氧化应激的影响。方法 选取2021年6月—2023年6月新乡医学院第二附属医院收治的104例老年PSD患者,采用随机数字表法分为对照组和研究组,每组各52例,分别接受舍曲林、艾地苯醌联合舍曲林治疗,疗程为8周。观察2组治疗前和治疗4、8周的汉密尔顿抑郁量表(HAMD)评分变化,评估临床疗效及治疗前后的认知功能[简易智力状态检查量表(MMSE)、韦氏成人记忆量表(WMS-RC)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)]及安全性。结果 2组HAMD评分比较组间效应、时间效应及交互效应均有统计学意义(P<0.05),治疗4、8周后研究组HAMD评分低于对照组,且研究组HAMD评分随时间延长降低趋势更为明显;研究组临床总有效率为96.15%(50例),高于对照组的82.69%(43例,χ^(2)=4.981,P=0.026);与治疗前比较,2组治疗后MMSE评分、长时记忆、短时记忆、即刻记忆、记忆商数、血清SOD及GSH-PX活性均升高,且研究组上述指标更高(P<0.05);治疗后2组MDA水平与治疗前比较均降低,且研究组更低(P<0.05);研究组不良反应发生率为9.61%(5例),与对照组(5.77%,3例)比较差异无统计学意义(P>0.05)。结论 老年PSD患者应用艾地苯醌联合舍曲林有助于减轻抑郁症状,提高临床疗效,改善认知功能,减轻氧化应激损伤,安全可靠。Objective To investigate the efficacy of idebenone combined with sertraline in elderly patients with post-stroke depression(PSD),and to analyze its effect on cognitive function and oxidative stress.Methods A total of 104 cases elderly patients with PSD were Seleeted and divided into a control group and study group,52 cases in each group,and were treated with sertraline,edbenquinone combined with sertraline for 8 weeks,respectively.The Hamilton depression scale(HAMD)scores of the two groups were observed before treatment,4 and 8 weeks after treatment.The clinical efficacy,cognitive function[mini-mental state examination(MMSE),Webster's adult memory scale(WMS-RC)],oxidative stress index[superoxide dismutase(SOD)activity,malondialdehyde(MDA)level,glutathione peroxidase(GSH-PX)activity]before and after treatment and safety were evaluated.Results After 4 and 8 weeks of treatment,the inter-group effect,time effect,and interaction effect were significant(P<0.05).The HAMD score of the study group was lower than that of the control group after 4 and 8 weeks of treatment,and the HAMD score of the study group had a more obvious decreasing trend with the extension of time.The total clinical effective rate was 96.15%(50 cases)in the study group and 82.69%(43 cases)in the control group,and the study group was higher than the control group(χ^(2)=4.981,P=0.026).Compared with before treatment,MMSE scores,long-term memory,short-term memory,immediate memory,memory quotient,serum SOD and GSH-PX activities were increased in both groups after treatment,and higher in the study group(P<0.05).The MDA levels in the 2 groups after treatment were decreased compared with before treatment,especially in the study group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(9.61%,5 cases)and the control group(5.77%,3 cases,P>0.05).Conclusion The use of idbenquinone combined with sertraline in elderly PSD patients is safe and reliable in alleviating depressive symptoms,improving clinical effica

关 键 词：脑卒中 抑郁症 艾地苯醌 认知功能 氧化应激 老年 

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