艾司西酞普兰对脑卒中后抑郁症患者心理状态和生活质量的影响

目的:探讨艾司西酞普兰对脑卒中后抑郁症(PSD)患者心理状态和生活质量的改善效果。方法:将132例PSD患者随机分为艾司西酞普兰组和阿米替林组,分别采用艾司西酞普兰和阿米替林进行治疗,疗程均为6周。分别采用汉密尔顿抑郁量表和世界卫生组织生存质量测定量表简表对治疗前后患者心理状态和生活质量进行评价;采用副反应量表评分法对药物不良反应进行评价。结果:治疗2周和4周时,艾司西酞普兰组汉密尔顿抑郁量表评分均显著低于阿米替林组(P<0.01)。治疗6周时,2组HAMD评分差异无统计学意义(P>0.05);艾司西酞普兰组的生存质量平均评分显著高于阿米替林组(P<0.01)。治疗2周、4周和6周时,艾司西酞普兰组的副反应量表评分均显著低于阿米替林组(P<0.01)。结论:艾司西酞普兰林在改善PSD患者心理状态的长期疗效与阿米替相似,但是在改善近期心理状态的效果优于阿米替林。此外,艾司西酞普兰改善患者生活质量的效果优于阿米替林,并且不良反应程度较轻。

Effect of escitalopram on psychology and quality of life in patients suffering from post-stroke depression

OBJECTIVE To evaluate the effect of escitalopram on psychology and quality of life in patients suffering frol post-stroke depression(PSD).METHODS 132 PSD patients were randomly divided into escitalopram group and amitriptyline group,and respectively received escitalopram and amitriptyline.The treatment course was 6 weeks.The efficacy on psychology and quality of life was evaluated by Hamilton Rating Scale for depression(HAMD) and World Health Organization Quality of Life-Brief Version(WHOQOL-BREF) before and after treatment in both groups.The adverse reaction was evaluated by the Treatment Emergent Symptom Scale(TESS).RESULTS The HAMD scores in escitalopram group at 2nd and 4th week were respectively 17.3±4.2 and 14.0±3.2,which were both significantly lower than those in amitriptyline group(P<0.01),but the HAMD scores in both group at 6th week were not significantly different(P>0.05).The mean WHOQOL-BREF score in escitalopram group at 6th week was 22.4±3.3,which was significantly higher than that in escitalopram group(P<0.01).TESS scores in the escitalopram group at 2nd,4th and 6th week were respectively 2.52±0.46,3.08±0.73 and 3.54±0.89,which were significantly lower than those in amitriptyline group(P<0.01).CONCLUSION Escitalopram and amitriptyline have the resemble long-term effect on the psychology in patients with post-stroke depression,but escitalopram has better short-term effect on the psychology;escitalopram has better effect on the quality of life in patients suffering from post-stroke depression,and has more slight adverse reactions.