小脑顶核电刺激对脑卒中后抑郁及日常活动能力的影响

目的探讨小脑顶核电刺激对脑卒中后抑郁患者血浆单胺类递质、抑郁状态及日常生活活动能力的影响。方法将40例脑卒中后抑郁患者随机分为治疗组和对照组,治疗组在常规治疗的基础上加用小脑顶核电刺激。分别于治疗前、治疗后采用高效液相-电化学检测器检测血浆中单胺类神经递质5-HT、NE的含量,采用汉密尔顿抑郁量表（HAMD）和Barthel指数评分（BI）对两组患者进行疗效评定。结果脑卒中后抑郁患者治疗前血浆中单胺类递质的含量较脑卒中非抑郁患者明显减少;治疗20d后,治疗组和对照组血浆5-HT、NE的含量均有上升,对照组组内比较差异无统计学意义,而电刺激治疗组组内和组间比较差异均具有统计学意义（P〈0.05,P〈0.01）;治疗前两组HAMD和Barthel指数评分（BI）差异均无统计学意义（P〉0.05）;治疗后治疗组的各项评分优于对照组（P〈0.05,P〈0.01）。结论小脑顶核电刺激能显著改善脑卒中后抑郁患者的抑郁状态和日常生活活动能力,其机制可能与它促进了单胺类神经递质的释放和其显著改善脑血流量有关。

Influence of electric stimulation on fastigial nucleus on monoamine transmitters and ADL in patients with post-stroke depression

Objective To investigate the effect of fastigial nucleus electric stimulation on monoamine transmitters, depression and ADL in patients with post-stroke depression. Methods 40 patients with PSD were divided into treatment group and control group. All patients were given routine treatment, in addition to fastigial nucleus electric stimulation in the treatment group. The concentrations of monoamine neurotransmitters were examined in plasma before and after treatment. The patients were evaluated with Hamilton Depression Scale （HAMD） and Barthel Index （BI）. Results The concentrations of monoamine neurotransmitters in plasma of poststroke depression patients was obviously lower than that of patients without depression（P〈0. 01）. After treatment, the concentrations of monoamine neurotransmitters in the treatment group was higher than that of the control group（P〈0. 05, P〈0.01）. There were no significant differences in the control group（P〉0. 05）. The scores of HAMD and ADL of treatment group were better than that of the control group （P〈0.05,P〈0.01）. Conclusion Fastigial nucleus electric stimulation can relieve depression, promote ADL of the patients with post-stroke depression, which is associated with the increased concentrations of monoamine neurotransmitters and cerebral blood flow.