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舍曲林与帕罗西汀治疗脑卒中后抑郁的疗效与安全性比较
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| 篇名： | 舍曲林与帕罗西汀治疗脑卒中后抑郁的疗效与安全性比较 |
| TITLE： | |
| 摘要： | 目的：比较舍曲林与帕罗西汀治疗脑卒中后抑郁的疗效和安全性。方法：回顾性分析91例脑卒中后抑郁患者资料，按用药方案的不同分为观察组（42例）和对照组（49例）。在常规治疗的基础上，观察组患者口服盐酸舍曲林片第1周起始剂量50 mg，每日1次，后每隔1周增加50 mg，最大剂量不超过200 mg；对照组患者口服盐酸帕罗西汀片第1周起始剂量10 mg，每日1次，后每隔1周增加10 mg，最大剂量不超过40 mg。两组疗程均为2个月。观察两组患者的临床疗效，治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、简易智力状态检查量表（MMSE）评分、汉密尔顿抑郁量表（HAMD）评分及血清5-羟色胺（5-HT）、脑源性神经营养因子（BDNF）、神经生化标志物（S100β）水平，并评价观察组患者治疗后血清5-HT、BDNF及S100β水平与HAMD评分的相关性；记录不良反应发生情况。结果：观察组患者总有效率（90.48％）显著高于对照组（73.47％），差异有统计学意义（P＜0.05）。治疗后，两组患者NIHSS评分、HAMD评分及S100β水平均显著低于同组治疗前，且观察组HAMD评分、S100β水平均显著低于对照组；两组患者MMSE评分及血清5-HT、BDNF水平均显著高于同组治疗前，且观察组显著高于对照组，差异均有统计学意义（P＜0.05）；但两组患者NIHSS评分比较，差异无统计学意义（P＞0.05）。治疗后观察组患者血清5-HT、BDNF水平与HAMD评分呈负相关， S100β水平与HAMD评分呈正相关。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规治疗的基础上，舍曲林治疗脑卒中后抑郁的疗效显著优于帕罗西汀，可改善患者抑郁状态及认知功能，且二者在改善神经功能、精神状态及安全性方面相当。 |
| ABSTRACT： | OBJECTIVE： To compare the therapeutic efficacy and safety of sertraline and paroxetine in the treatment of post stroke depression. METHODS： The information of 91 patients with post stroke depression were analyzed retrospectively and divided into observation group （42 cases） and control group （49 cases） according to therapy plan. Based on routine treatment， observation group was given Sertraline hydrochloride tablet orally with initial dose of 50 mg at first week， once a day， increasing by 50 mg each week， no more than 200 mg. Control group was given Paroxetine tablet with initial dose of 10 mg， once a day， increasing by 10 mg each week， no more than 40 mg. Treatment course of 2 groups lasted for 2 months. Clinical efficacies of 2 groups were observed. NIHSS score， MMSE score， HAMD score， the serum levels of 5-HT， BDNF and S100β were observed before and after treatment， and the correlation of serum levels of 5-HT， BDNF and S100β with HAMD score were evaluated in observation group after treatment； the occurrence of ADR was recorded. RESULTS： The total response rate of observation group （90.48％） was significantly higher than that of control group （73.47％）， with statistical significance （P＜0.05）. After treatment， NIHSS score， HAMD score and S100β level of 2 groups were significantly lower than before treatment， and HAMD score and S100β level of observation group were significantly lower than those of control group. MMSE score， serum levels of 5-HT and BDNF in 2 groups were significantly higher than before treatment， and the observation group was significantly higher than the control group， with statistical significance （P＜0.05）. There was no statistical significance in NIHSS score between 2 groups （P＞0.05）. The serum levels of 5-HT and BDNF were negatively correlated with HAMD score in observation group after treatment， and the level of S100β was positively correlated with HAMD score. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Based on routine treatment， therapeutic efficacy of sertraline is significantly better than that of paroxetine in the treatment of post stroke depression， and can improve cognitive function and depression. The two drugs are similar in improving nerve function and mental state， safety. |
| 期刊： | 2017年第28卷第36期 |
| 作者： | 李丕武，王海燕，孙玲，张斌 |
| AUTHORS： | LI Piwu，WANG Haiyan，SUN Ling，ZHANG Bin |
| 关键字： | 舍曲林；帕罗西汀；脑卒中后抑郁；认知功能；疗效；安全性 |
| KEYWORDS： | Sertraline； Paroxetine； Post stroke depression； Cognitive function； Therapeutic efficacy； Safety |
| 阅读数： | 280 次 |
| 本月下载数： | 3 次 |
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