舍曲林与帕罗西汀治疗脑卒中后抑郁症对患者神经递质功率及抑郁情绪的影响比较  

Comparison of the Effects of Sertraline and Paroxetine on Neurotransmitter Power and Depressive Mood in Patients with Post-Stroke Depression

作　　者：申贵玉 黄焱 谢清芳[1] 王能琨 黄海东 SHEN Guiyu;HUANG Yan;XIE Qingfang(Shanghai Baoshan District Mental Health Center,Shanghai 201900)

机构地区：[1]上海市宝山区精神卫生中心精神科,上海201900 [2]上海市宝山区精神卫生中心门诊,上海201900

出　　处：《医学临床研究》2025年第4期638-641,共4页Journal of Clinical Research

摘　　要：【目的】比较舍曲林与帕罗西汀治疗脑卒中后抑郁症对患者神经递质功率及抑郁情绪的影响。【方法】140例脑卒中后抑郁症患者,根据治疗方法不同分为A组、B组,每组70例。两组均给予常规对症治疗,A组同时给予舍曲林治疗,B组同时给予帕罗西汀治疗。比较两组治疗前后汉密尔顿抑郁量表-24项版(HAMD)评分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、Asberg抗抑郁药不良反应量表(SERS)评分;比较两组治疗前后γ-氨基丁酸(GABA)、乙酰胆碱(Ach)、谷氨酸(Glu)、去甲肾上腺素(NE)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)水平及两组疗效。【结果】A组总有效率为92.86%(65/70),高于B组的80.00%(56/70)(P<0.05)。治疗4周和8周后,两组HAMD评分逐渐下降(P<0.05),A组HAMD评分低于B组(P<0.05)。治疗4周和8周后,两组GABA、Ach、Glu、NE水平和BI评分逐渐上升(P<0.05),A组GABA、Ach、Glu、NE水平和BI评分高于B组(P<0.05)。治疗4周和8周后,两组患者IL-2、TNF-α水平和NIHSS评分逐渐下降(P<0.05),且A组IL-2、TNF-α水平和NIHSS评分低于B组(P<0.05)。A组治疗4周和8周后SERS评分均低于B组(P<0.05)。【结论】舍曲林治疗脑卒中后抑郁症患者,可有效改善患者负性情绪,提高神经递质功率,减少神经功能损伤,且安全性高。【Objective】To compare the effects of sertraline and paroxetine on neurotransmitter power and depression in patients with post-stroke depression.【Methods】A total of 140 patients with post-stroke depression were divided into two groups according to different treatment methods,with 70 cases in each group.Both groups were given conventional symptomatic treatment,while group A was also given sertraline treatment,while group B was given paroxetine treatment.The changes in Hamilton Depression Rating Scale-24(HAMD)score,National Institutes of Health Stroke Scale(NIHSS)score,Barthel Index(BI)score,Asberg Antidepressant Side Effects Rating Scale(SERS)score before and after treatment were compared between the two groups.The changes in gamma-aminobutyric acid(GABA),acetylcholine(Ach),glutamate(Glu),norepinephrine(NE),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)levels before and after treatment,as well as the efficacy of the two groups,were also compared.【Results】The total effective rate of group A was 92.86%(65/70),which was higher than that of group B(80.00%,56/70)(P<0.05).After 4 weeks and 8 weeks of treatment,the HAMD scores of the two groups gradually decreased(P<0.05),and the HAMD score of group A was lower than that of group B(P<0.05).After 4 weeks and 8 weeks of treatment,the levels of GABA,Ach,Glu,NE,and BI scores gradually increased in both groups(P<0.05),while the GABA,Ach,Glu,NE,and BI scores in group A were higher than those in group B(P<0.05).After 4 weeks and 8 weeks of treatment,the IL-2,TNF-α,and NIHSS scores gradually decreased in both groups(P<0.05),and the IL-2,TNF-α,and NIHSS scores in group A were lower than those in group B(P<0.05).The SERS scores of group A were lower than those of group B after 4 weeks and 8 weeks of treatment(P<0.05).【Conclusion】Sertraline treatment for post-stroke depression can effectively improve patients'negative emotions,increase neurotransmitter power,reduce neural functional damage,and have high safety.

关 键 词：卒中 抑郁症 舍曲林 帕罗西汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学]