神经药理学报

神经药理学报 ›› 2021, Vol. 11 ›› Issue (3): 10-14.DOI: 10.3969/j.issn.2095-1396.2021.03.003

• 研究论文 • 上一篇    下一篇

丁苯酞联合舍曲林对缺血性脑卒中后抑郁患者的临床疗效及炎性细胞因子的影响

董传占，王丽春   

  1. 单县海吉亚医院神经内科，菏泽，274300，中国
  • 出版日期:2021-06-26 发布日期:2021-06-26
  • 作者简介:董传占，男，主治医生；研究方向：主要从事脑血病诊断治疗；E-mail：ssmunn@126.com

Clinical Efficacy of Butylphthalide Combined with Sertraline in the Treatment of Post-stroke Depression and Its Effect on Inflammatory Factors

DONG Chuan-zhan，WANG Li-chun   

  1. Hygeia Hospital of Shanxian，Heze，274300，China
  • Online:2021-06-26 Published:2021-06-26

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摘要：

目的：分析缺血性脑卒中后抑郁（post-ischemic stroke depression，PISD）患者实施丁苯酞和舍曲林联合治疗后的情绪、认知功能以及炎症状态改变。方法：将符合筛选条件的PISD 患者126 例随机分为对照组和实验组两组，分别采用舍曲林和丁苯肽联合舍曲林治疗方法，对比分析两组患者炎症状态、HPA 轴功能以及疾病恢复状态。结果：治疗前，PISD 患者神经功能、抑郁状态、认知功能以及HPA 轴功能在两组之间无明显差异；治疗后，两组患者神经功能、抑郁状态、认知情况以及HPA 轴功能均有所改善，其中与对照组比较，实验组患者神经功能缺损程度（National Institute of Health Stroke Scale，NIHSS）评分和汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD）评分偏低而智力状况评估量表（Mental Status Assessment Scale，MMSE）评分明显高；实验组患者血清促肾上腺皮质激素释放激素（corticotropin releasing hormone，CRH）、促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）及皮质醇（cortisol，Cor）水平明显低于对照组。与对照组比，实验组患者hs-CRP、TNF-α、IL-8等明显较低（P<0.05）。与对照组相比，实验组63 例患者总治愈人数为60 例（95.2%），明显高于对照组，两组之间的差异显著（P<0.05）。与对照组比，实验组患者躯体健康、心理健康、社会功能以及物质生活四方面生活质量评分明显较高。结论：丁苯酞联合舍曲林治疗方式能有效改善PISD 患者血液炎症因子水平，改善HPA 轴功能，提高患者认知功能，降低精神损伤以及抑郁严重程度。

关键词: 丁苯酞, 舍曲林, 缺血性脑卒中, 炎症因子, 临床疗效

Abstract:

Objective：To analyze the changes of emotion，cognitive function and inflammatory state in patients with post-ischemic stroke depression （PISD） after treatment with butylphthalide and sertraline. Methods：126 PISD patients who met the screening criteria were randomly divided into control group and experimental group. Sertraline and butylphenylpeptide combined with sertraline were used to treat PISD patients，and the inflammation status and inflammation status of the two groups were compared and analyzed. Results：Before treatment，there was no significant difference in neurological function，depressive state，cognitive function and HPA axis function between the two groups in PISD patients.After treatment，the neurological function，depressive state，cognitive status and HPA axis function of the two groups were improved. Compared with the control group，the NIHSS and Hamilton Depression Scale（HAMD） scores of the experimental group were lower，while the MMSE scores were significantly higher. The HAMD score was low while the Mental Status Assessment Scale （MMSE） score was significantly high. The levels of serum corticotropin releasing hormone （CRH），corticotropin（ACTH） and cortisol （Cor） in the experimental group were significantly lower than those in the control group. Compared with the control group，hs-CRP，TNF-alpha，IL-8 in the experimental group were significantly lower （P<0.05）. Compared with the control group，the total number of
patients cured in the experimental group was 60 （95.2%），which was significantly higher than that in the control group，and the difference between the two groups was significant （P<0.05）. Compared with the control group，the experimental group had significantly higher scores in four aspects of physical health，mental health，social function and material life. Conclusion：
Butylphthalide combined with sertraline can effectively improve the level of inflammatory factors in PISD patients，improve HPA axis function，improve cognitive function，and reduce the severity of mental injury and depression.

Key words: butylphthalide；sertraline；ischemic stroke；inflammatory factors；clinical , efficacy

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