阿戈美拉汀在缺血性脑卒中后抑郁中的应用

目的:观察阿戈美拉汀治疗缺血性脑卒中伴抑郁的临床疗效及对神经细胞因子的影响。方法:111例患者随机分为对照组55例和观察组56例,两组均予卒中常规治疗,对照组加服艾司西酞普兰,观察组加服阿戈美拉汀。均治疗6周。分别采用HAMD量表、NIHSS量表、PSQI量表评价抑郁、神经功能缺损和睡眠障碍,多导睡眠监测仪记录睡眠参数,ELISA法测定血清脑源性神经营养因子(BDNF)、胶质细胞源性神经营养因子(GDNF)、神经生长因子(NGF)、睫状神经营养因子(CNTF)含量,记录不良反应。结果:治疗3周,观察组抗抑郁有效率为58.9%,高于对照组38.2%。与对照组相比,治疗3周和治疗6周时,观察组PSQI量表评分均明显降低;治疗6周时,观察组睡眠潜伏期(SL)、觉醒总时间(AT)缩短,总睡眠时间(TST)、睡眠效率(SE),血清BDNF、CNTF含量明显增加(P<0.05)。其余指标组间相近(P>0.05)。结论:阿戈美拉汀对缺血性脑卒中伴抑郁具有良好治疗作用,其机制可能与提高血清神经细胞因子含量有关。

Application of agomelatine for depression after ischemic stroke

OBJECTIVE To observe the clinical efficacy of agomelatine in the treatment of ischemic stroke with depression and its effect on neural cell factor.METHODS 111 cases with depression after ischemic stroke were randomly divided into control group (55 cases) and study group (56 cases).Both groups were given routine treatment of stroke.The control group was given escitalopram and the observation group was given agomelatine.All patients were treated for 6 weeks.Depression,neurological deficits,and sleep disorders were evaluated using the HAMD scale,NIHSS scale,and PSQI scale,respectively,sleep parameters were recorded by polysomnography,and serum brain-derived neurotrophic factor (BDNF),glial cell line-derived neurotrophic factor (GDNF),nerve growth factor (NGF),and ciliary neurotrophic factor (CNTF) contents were measured by ELISA to record adverse effects.RESULTS After treatment of 3 weeks,the cure rate of depression was 58.9% in the study group,which was higher than that of control group of 38.2% (P<0.05).Compared with those in control group,after treatment of 3 weeks and 6 weeks,the scores of PSQI in study group were lower;after treatment of 6 weeks,the SL and AT were decreased,the TST,SE,the serum levels of BDNF and CNTF were increased (P<0.05).The other indexes were similar between two groups (P>0.05).CONCLUSION Agomelatine has a good therapeutic effect on ischemic stroke with depression,and the mechanism may be related to the increase of serum nerve cell factor content.