西酞普兰与氟西汀治疗卒中后抑郁对照研究

目的探讨西酞普兰治疗卒中后抑郁的临床疗效及安全性和对神经功能康复的影响。方法将54例卒中后抑郁患者随机分为西酞普兰组和氟西汀组各27例,观察治疗6w。于治疗前及治疗1w、2w、4w、6w末采用汉密顿抑郁量表和副反应量表评定抗抑郁疗效和不良反应,爱丁堡-斯堪的那维亚卒中量表评定神经功能缺损程度。结果治疗6w末西酞普兰与氟西汀治疗卒中后抑郁显效率分别为74.1%、70.4%;神经功能康复显效率分别为63.0%、55.6%。汉密顿抑郁量表评分西酞普兰组治疗1w末起较治疗前有极显著性下降（P〈0.01）;氟西汀组治疗2w末起有极显著性下降（P〈0.01）。爱丁堡-斯堪的那维亚卒中量表评分两组治疗6w末均较治疗前有极显著性下降（P均〈0.01）。两组不良反应均轻微,副反应量表评分无显著性差异（P〉0.05）。结论西酞普兰治疗卒中后抑郁疗效与氟西汀相当,且起效更快,安全性高,依从性好,有利于患者神经功能的康复。

A control study citalopram vs. fluoxetine in the treatment of post-stroke depression

Objectives To explore the effectiveness,safety and contributions to nervous functional rehabilitation of citalopram in the treatment of post-stroke depression(PSD).Methods 54 patients with PSD were randomly assigned into citalopram and fluoxetine groups(each n=27)for 6 weeks.Clinical effectiveness were assessed with the Hamilton Depression Scale(HAMD),adverse reactions with the Treatment Emergent Symptoms Scale(TESS)and nervous functional impairment with the MESSS before treatment and at the ends of the 1st,2nd,4th and 6th week treatment,respectively.Results At the and of 6th week,excellence rates were 74.1% in the citalopram and 70.4% in the fluoxetine group and those of nervous functional rehabilitation 63.0% and 55.6%,respectively.In the citalopram group score of the HAMD decreased very significantly since the end of the 1st week compared with pre-treatment(P<0.01)and in the fluoxetine group since the end of 2nd week(P<0.01).Scores of the MESSS of both groups decreased very significantly at the end of 6th week compared with pre-treatment(both P<0.01).The adverse reactions of both groups were milder and there was no significant difference in score of the TESS(P>0.05).Conclusion Citalopram has therapeutic equivalence to fluoxetine,takes effects faster,has higher safety and better compliance,and is in favor of the rehabilitation of nervous function.