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目的脑卒中后抑郁不仅会加重患者脑卒中症状,同时还会增加患者精神上的痛苦,严重威胁患者生命安全,为了减轻患者的抑郁症状,增强预后效果,发掘更好的药物治疗十分重要,因此本研究通过探讨艾司西酞普兰与舍曲林对脑卒中后抑郁患者疗效及对炎症因子、NSE、NPY的影响为临床提供依据。方法选取2015年3月—2016年10月浙江省立同德闲林分院脑卒中后抑郁患者98例,采用随机数字表法分为观察组和对照组,各49例。观察组患者在常规治疗的基础上加用艾司西酞普兰进行治疗,对照组患者在常规治疗的基础上加用舍曲林进行治疗,2组患者均治疗8周。观察2组患者治疗效果,比较治疗前后2组炎症因子肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)及神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)变化。结果观察组患者治疗总有效率为89.80%,对照组治疗总有效率为79.59%,2组患者治疗总有效率差异无统计学意义(P>0.05);2组患者治疗后炎症因子IL-6、TNF-α水平均明显降低(P<0.05),且观察组患者降低更显著(P<0.05);2组患者治疗后NSE均较治疗前显著降低(P<0.05),NPY均较治疗前显著升高(P<0.05),且观察组变化更显著(P<0.05);观察组患者不良反应率为24.49%,对照组患者不良反应率为32.65%,2组患者治疗不良反应率差异无统计学意义(P>0.05)。结论艾司西酞普兰与舍曲林治疗脑卒中后抑郁患者均疗效可靠,不良反应均轻微,但艾司西酞普兰对炎症因子IL-6、TNF-α及NSE、NPY水平的改善效果更好。
Objective Depression after stroke not only aggravates stroke symptoms in patients, but also increases mental distress in patients and threatens the life safety of patients. It is very important to find out better drug treatment in order to reduce the depressive symptom, enhance the prognosis and improve the prognosis of patients. This study was to explore the effects of escitalopram and sertraline on the clinical response to stroke patients with post-stroke depression and their effects on inflammatory factors, NSE and NPY. Methods From March 2015 to October 2016, 98 patients with post-stroke depression in Tongde Freezing Branch of Zhejiang Province were selected and randomly divided into observation group and control group with 49 cases in each group. Patients in the observation group were treated with escitalopram on the basis of conventional treatment. Patients in the control group were treated with sertraline on the basis of conventional treatment, and both groups were treated for 8 weeks. The therapeutic effect was observed in two groups. The levels of tumor necrosis factor (TNF-α), interleukin-6 (IL-6), neuron specific enolase (NSE) and neuropeptide Y )Variety. Results The total effective rate was 89.80% in the observation group and 79.59% in the control group. There was no significant difference in the total effective rate between the two groups (P> 0.05). The inflammatory factors IL-6 (P <0.05). The NSE in the two groups were significantly lower than that before treatment (P <0.05), and the levels of TNF-α in the two groups were significantly lower than those before treatment (P <0.05) (P <0.05). The adverse reaction rate was 24.49% in the observation group and 32.65% in the control group. There was no significant difference in adverse reactions between the two groups Statistical significance (P> 0.05). Conclusions Both escitalopram and sertraline are effective in the treatment of post-stroke depression patients with mild side effects, but escitalopram is more effective in improving the levels of inflammatory cytokines IL-6, TNF-α, NSE and NPY it is good.