氟西汀对脑卒中抑郁患者不同时期神经功能康复的作用

目的:探讨氟西汀抗抑郁治疗对卒中后抑郁(Post-StrokeDepression,PSD)患者神经功能康复的影响。方法:选取经临床体格检查、头颅CT或MRI确诊的急性脑卒中患者132例(脑梗死78例,脑出血54例)。将符合DSM-Ⅳ抑郁症诊断标准的脑卒中患者随机分成抑郁治疗组和抑郁对照组,治疗组予氟西汀治疗。分别在病程2周、1月、3月、6月、12月时给每一位入组患者行神经功能缺损评分(SSS)、日常生活能力评分(ADL)、汉密尔顿抑郁量表(HAMD)、Zung's抑郁自评量表(SDS)和焦虑自评量表(SAS)评分。结果:脑卒中患者中约44.7%出现抑郁症状;抗抑郁药物PROZAC(盐酸氟西汀)能明显改善病程3,6月时神经功能缺损,病程12月时不仅抑郁症状减轻,ADL能力改善,神经功能缺损减轻尤为显著。结论:抗抑郁治疗能使PSD患者抑郁症状明显改善的同时,显著提高ADL能力和神经功能。

Study of effect on neurologic function rehabilitation in patient with post-stroke depression

AIM:To explore the effect of anti depression drug treatment on functional rehabilitation of PSD (Post Stroke Depression).METHODS:We studied 132 cases with acute cerebrovascular disease diagnosed by clinical physical examination and cranial examine with XCT and MRI, which involved in 78 patients with cerebral infarction (CI) and 54 cases with cerebral hemorrhage (CH).We diagnosed PSD and estimated SSS, ADL, HAMD, SDS and SAS scales for all patients at 2 weeks,1,3,6 and 12months.PROZAC(Fluoxetine Hydrochloride) 20 mg per moning was administered in the group of anti depressive treatment.RESULTS:(1) The morbidity of PSD was 44.70%;(2)Anti depressive drug PROZAC can ameliorate neurologic impairment during the course of 3 and 6 months, furthermore relieve depression symptom and defect of ability in daily living and more neurologic impairment at 12 months.CONCLUSION:Anti Depressive therapeutics could ameliorate the symptom of depression and improve the ability of daily living and neurologic function notably.