米那普侖治療老年卒中后抑郁的臨床療效

于志軍 杜斌 么憲偉

[摘要] 目的 探討米那普侖對比舍曲林治療老年卒中后抑郁癥的臨床療效和不良反應(yīng)。 方法 選取2018年1月～2019年6月我院收治的48例診斷為腦卒中后抑郁的老年患者，隨機(jī)分為兩組，研究組使用米那普侖，對照組使用舍曲林，治療8周，采用漢密爾頓抑郁量表（HAMD）和神經(jīng)功能缺損量表（CSS）、匹茲堡睡眠質(zhì)量指數(shù)量表（PSQI）、副反應(yīng)量表（TESS）評定臨床療效、睡眠質(zhì)量指數(shù)和不良反應(yīng)。 結(jié)果 研究組和對照組治療老年腦卒中后抑郁的HAMD、CSS、PSQI評分無顯著性差異，總有效率分別為88.0%和91.3%，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）;副反應(yīng)量表顯示研究組與對照組均未出現(xiàn)嚴(yán)重不良反應(yīng)，兩組間無統(tǒng)計(jì)學(xué)差異（P>0.05）。 結(jié)論 米那普侖有利于老年腦卒中后抑郁患者改善抑郁癥狀，促進(jìn)神經(jīng)功能康復(fù)，提高生活能力，是一種安全有效、副反應(yīng)少的抗老年卒中后抑郁藥。

[關(guān)鍵詞] 米那普侖;舍曲林;卒中后抑郁;副反應(yīng)

[中圖分類號] R749.4 ? ? ? ? ?[文獻(xiàn)標(biāo)識碼] B ? ? ? ? ?[文章編號] 1673-9701（2020）12-0090-04

[Abstract] Objective To investigate the clinical efficacy and adverse reactions of milnacipran versus sertraline in the treatment of post-stroke depression in the elderly. Methods 48 elderly patients diagnosed with post-stroke depression who were admitted in our hospital from January 2018 to June 2019 were selected and randomly divided into two groups. The study group was given milnacipran and the control group was given sertraline， for 8 weeks. The hamilton depression scale（HAMD） and neurological deficiency scale（CSS），the pittsburgh sleep quality index scale（PSQI），and the side effects scale（TESS） were used to assess clinical efficacy，sleep quality index， and adverse reactions. Results There were no statistically significant differences in the HAMD，CSS，and PSQI scores in the study group and the control group in the treatment of post-stroke depression in the elderly. The total effective rates were 88.0% and 91.3%，respectively. The differences were not statistically significant（P>0.05）; The adverse reaction scale showed that there were no serious adverse reactions in the study group and the control group， and there was no statistical difference between the two groups（P>0.05）. Conclusion Milnacipran is beneficial to the elderly patients with post-stroke depression to improve the symptoms of depression， to promote the rehabilitation of neurological function，and to improve their living ability，which is a safe and effective anti-post-stroke depression drug with few adverse reactions for the elderly.

[Key words] Milnacipran; Sertraline; Post-stroke depression; Adverse effects

腦卒中后抑郁（Post-stroke depression，PSD）是指腦卒中后出現(xiàn)抑郁癥狀，且癥狀持續(xù)2周以上，臨床表現(xiàn)主要為情緒低落、思維遲緩、睡眠障礙等[1]，有研究表明其發(fā)生率在20%～40%[2-3]，卒中后抑郁作為腦卒中的常見并發(fā)癥，嚴(yán)重影響患者神經(jīng)功能恢復(fù)，降低生存質(zhì)量，影響疾病的治療和預(yù)后[4-5]。選擇性5-羥色胺（5-HT）再攝取抑制類抗抑郁藥是當(dāng)前臨床針對抑郁癥的主要治療方法，其中舍曲林屬于一線治療藥物，本文通過對老年卒中后抑郁患者進(jìn)行對比治療研究，探討米那普侖對老年卒中后抑郁的治療效果，現(xiàn)報(bào)道如下。……