目的 觀察舍曲林預防老年腦卒中后抑郁癥狀及神經(jīng)功能缺損的臨床療效.方法 選取保定市第一中心醫(yī)院2013年1月—2014年1月符合納入標準的腦卒中患者90例,隨機分成對照組(30例)、干預一組(30例)、干預二組(30例).對照組給予基礎治療.干預一組在此基礎上晨起口服鹽酸舍曲林分散片,起始劑量50 mg/d,3 d后增至100 mg/d.干預二組在基礎治療上晨起口服鹽酸舍曲林分散片,起始劑量50 mg/d,3 d后增至100 mg/d,1周內(nèi)增加至150 mg/d.3組均持續(xù)用藥2個月.在治療前,治療1、2個月分別測定漢密爾頓抑郁量表(HAMD)及神經(jīng)功能缺損(NFI)評分,并計算患者的依從性.結果 治療1、2個月后,2組干預組抑郁癥發(fā)生率顯著低于對照組,差異有統(tǒng)計學意義(P<0.05).治療1、2個月后,3組患者的HAMD及NFI評分均較治療前明顯下降,同組治療前后差異有統(tǒng)計學意義(P<0.05);且治療后,兩組干預組HAMD及NFI評分均較對照組下降更明顯(P<0.05).治療第1、2、4周兩組干預組患者依從率均高于對照組,差異有統(tǒng)計學意義(P<0.05).結論 100 mg舍曲林能有效地降低腦卒中患者抑郁癥的發(fā)生率,促進卒中后患者神經(jīng)功能的恢復,并能提高患者的依從性,值得臨床推廣.

Objective To observe the clinical effects of sertraline for preventing depression and neurologic impairment of elderly post-stroke depression (PSD). Methods The patients (90 cases) diagnosed as cerebral apoplexy in the First Central Hospital of Baoding City from January 2013 to January 2014 were randomly divided into control (49 cases), intervention group one (30 cases), and intervention group two (30 cases) groups. The patients in the control group were treated with basic treatment. The patients in intervention group one were given Sertraline Hydrochloride Dispersible Tablets, 50 mg/d in the morning for 3 d, and the dosage was gradually increased to 100 mg/d. The patients in intervention group two were given Sertraline Hydrochloride Dispersible Tablets, 50 mg/d in the morning for 3 d, and the dosage was gradually increased to 100 mg/d, while the dosage was gradually increased to 150 mg/d in one week. The patients in three groups were treated for 2 months. Hamihon depression scale (HAMD) and neurologic function impairment (NFI) scores were assessed before the treatment, one and two months after the treatment, and the compliance of patients in two groups was calculated. Results One and two months after the treatment, the incidence of depression in two intervention groups was higher than that in the control group, with the significant difference (P < 0.05). One and two months after the treatment, HAMD and NFI scores of the three groups were more significantly decreased than those before the treatment, and the difference was statistically significant in the same group (P < 0.05). HAMD and NFI scores of the two intervention groups were decreased more obviously compared with those in the control group (P < 0.05). The compliance rates in the two intervention groups were higher than that in control group, with the significant difference (P < 0.05) on one, two, and four week after treatment. Conclusion Sertraline with 100 mg can effectively lower the incidence of depression in patients with cerebral apoplexy, and at the same time, the therapy could promote the recovery of the neuronal function after stroke. Sertraline also can improve the patients' compliance rate, which is worth in clinical promotion.

保定市科技攻關計劃項目(13ZF016)