本文選題：腦梗死 + 抗抑郁藥��； 參考：《重慶醫(yī)學(xué)》2017年22期

【摘要】：目的探討預(yù)防性應(yīng)用抗抑郁藥對急性腦梗死預(yù)后及血清腦源性神經(jīng)營養(yǎng)因子(BDNF)水平的影響。方法前瞻性選擇2013年1月至2016年4月該院141例急性腦梗死患者,干預(yù)組72例,給予急性腦梗死常規(guī)治療同時(shí)加用鹽酸舍曲林治療12周,對照組69例,僅進(jìn)行常規(guī)治療。采用神經(jīng)功能缺損評分(NIHSS)及日常生活能力評定量表barthel(BI)指數(shù)評價(jià)神經(jīng)功能缺損程度及日常生活能力,漢密爾頓抑郁量表(HAMD)-17評價(jià)卒中后情緒,簡明智力狀態(tài)檢查(MMSE)評定認(rèn)知功能,用雙抗體夾心酶聯(lián)免疫吸附法檢測血清BDNF水平。結(jié)果治療3個(gè)月后,干預(yù)組NIHSS、HAMD評分分別為(1.77±0.58)分和(5.43±1.77)分,對照組分別為(4.06±0.79)分和(10.27±3.78)分,均較入組時(shí)明顯降低(P0.05);干預(yù)組和對照組BI分別為(96.24±4.58)和(77.64±6.96),均較入組時(shí)明顯升高(P0.05);干預(yù)組和對照組血清BDNF水平分別為(8.38±0.74)、(5.72±0.67)ng/mL,均較入組時(shí)明顯升高(P0.05),干預(yù)組高于對照組(P0.05)。MMSE評分兩組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)組PSD發(fā)生率(10.0%)較對照組(53.6%)明顯降低(P0.05)。結(jié)論急性腦梗死預(yù)防性應(yīng)用抗抑郁藥,可升高血清BDNF水平,改善預(yù)后,值得推廣應(yīng)用。
[Abstract]:Objective to investigate the effect of prophylactic antidepressants on the prognosis of acute cerebral infarction and the level of BDNF in serum.Methods from January 2013 to April 2016, 141 patients with acute cerebral infarction in this hospital were prospectively selected. 72 patients in the intervention group were treated with routine treatment of acute cerebral infarction and sertraline hydrochloride for 12 weeks, while 69 patients in the control group were treated with routine therapy only.NIHSS and BI were used to evaluate the degree of neurological impairment and the ability of daily living (ADL). Hamilton Depression scale (Hamilton Depression scale) was used to evaluate post-stroke emotion and cognitive function was evaluated by brief mental state test (MMSE).Serum BDNF levels were detected by double antibody sandwich enzyme linked immunosorbent assay (Elisa).Results after 3 months of treatment, NIHSS Hamd scores were 1.77 鹵0.58 and 5.43 鹵1.77 in the intervention group, and 4.06 鹵0.79 and 10.27 鹵3.78 in the control group, respectively.The BI of the intervention group and the control group were 96.24 鹵4.58 and 77.64 鹵6.96, respectively, which were significantly higher than that of the incoming group, and the serum BDNF levels of the intervention group and the control group were 8.38 鹵0.74 鹵0.67 ng / mL, respectively, which were significantly higher than those of the control group, which were higher than that of the control group.There was no significant difference between the two groups (P 0.05).The incidence of PSD in the intervention group (10.0) was significantly lower than that in the control group (53.6%).Conclusion prophylactic use of antidepressants in patients with acute cerebral infarction can increase serum BDNF level and improve prognosis.
【作者單位】： 江蘇省連云港市第二人民醫(yī)院神經(jīng)心理科;
【基金】：江蘇大學(xué)醫(yī)學(xué)臨床科技發(fā)展項(xiàng)目(JLY20140131)
【分類號】：R743.33

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