氟西汀治疗脑卒中后抑郁症临床观察

目的探讨氟西汀治疗脑卒中后抑郁症的临床疗效。方法选取脑卒中患者80例全部通过临床CT或MRI证实,治疗组40例,Zung抑郁自评量表≥40分,或者GDS老年抑郁量表5～10分;对照组40例是有部分抑郁症状但尚未达到抑郁标准的脑卒中患者。2组患者均给予相似的脑血管病常规治疗,针对治疗组增加氟西汀（百忧解胶囊）,每天晨服1粒（20mg）,连服8周。结果治疗组患者的Zung量表和GDS量表评分,在服用氟西汀治疗后4周和8周抑郁症状均不同程度好转,第8周与第4周相比好转更加明显。分析表明优势半球卒中和多发性脑卒中患者抑郁症状更为突出,治疗后疗效也更加明显;ADL评分发现治疗组总体疗效好于对照组,第8周好于第4周,亚组分析仅提示优势半球脑卒中治疗组的ADL疗效明显好于对照组。结论氟西汀能够调节5-羟色胺浓度,改善抑郁症状,促进ADL功能恢复。

Clinical observation of Fluoxine in the treatment of patients with poststroke depression

Objective To investigate the clinical efficacy of fluoxetine in treating poststroke depression. Methods Eighty cases of stroke patients who were verified through clinical CT or MRI were chosen： 40 cases in treatment group whose self rating depression scale scores（SDS）≥40 or geriatric depression scale scores（GDS） between 5 and 10;40 cases in control group who behaved partial depressive disorder but not yet up to standard stroke patients＇ requirement.The two groups were provided with similar conventional treatment of cerebrovascular disease,added fluoxetine（Prozac capsule） in the treatment group for 1 grain（20 mg） every morning during consecutive 8 weeks. Results The scores of SDS and GDS in the treatment group showed that symptom of patients who suffered from depression changed better after taking fluoxetine for 4 weeks and 8 weeks,and the depressive symptom in the eighth week improved remarkably than that in the fourth week.Subgroup analysis showed that depressive symptom of the advantaged cerebral hemisphere stroke multiple stroke patients were more prominent,and the effect after treatment was more prominent,too;According to ADL scores,the overall effect in treatment group was better than control group,and it was better in the 8th week than that in the 4th week.Subgroup analysis only point out ADL effect in the treatment group was obviously better than that in the control group on advantaged cerebral hemisphere stroke. Conclusion Fluoxetine is able to adjust the density of serotonin,improve the depressive symptom and promote the recovery of ADL function.