预防性应用抗抑郁药物对急性脑梗死预后及血清BDNF水平的影响

发布时间：2018-04-18 03:32

本文选题：脑梗死 + 抗抑郁药　；参考：《重庆医学》2017年22期

【摘要】：目的探讨预防性应用抗抑郁药对急性脑梗死预后及血清脑源性神经营养因子(BDNF)水平的影响。方法前瞻性选择2013年1月至2016年4月该院141例急性脑梗死患者,干预组72例,给予急性脑梗死常规治疗同时加用盐酸舍曲林治疗12周,对照组69例,仅进行常规治疗。采用神经功能缺损评分(NIHSS)及日常生活能力评定量表barthel(BI)指数评价神经功能缺损程度及日常生活能力,汉密尔顿抑郁量表(HAMD)-17评价卒中后情绪,简明智力状态检查(MMSE)评定认知功能,用双抗体夹心酶联免疫吸附法检测血清BDNF水平。结果治疗3个月后,干预组NIHSS、HAMD评分分别为(1.77±0.58)分和(5.43±1.77)分,对照组分别为(4.06±0.79)分和(10.27±3.78)分,均较入组时明显降低(P0.05);干预组和对照组BI分别为(96.24±4.58)和(77.64±6.96),均较入组时明显升高(P0.05);干预组和对照组血清BDNF水平分别为(8.38±0.74)、(5.72±0.67)ng/mL,均较入组时明显升高(P0.05),干预组高于对照组(P0.05)。MMSE评分两组差异无统计学意义(P0.05)。干预组PSD发生率(10.0%)较对照组(53.6%)明显降低(P0.05)。结论急性脑梗死预防性应用抗抑郁药,可升高血清BDNF水平,改善预后,值得推广应用。
[Abstract]:Objective to investigate the effect of prophylactic antidepressants on the prognosis of acute cerebral infarction and the level of BDNF in serum.Methods from January 2013 to April 2016, 141 patients with acute cerebral infarction in this hospital were prospectively selected. 72 patients in the intervention group were treated with routine treatment of acute cerebral infarction and sertraline hydrochloride for 12 weeks, while 69 patients in the control group were treated with routine therapy only.NIHSS and BI were used to evaluate the degree of neurological impairment and the ability of daily living (ADL). Hamilton Depression scale (Hamilton Depression scale) was used to evaluate post-stroke emotion and cognitive function was evaluated by brief mental state test (MMSE).Serum BDNF levels were detected by double antibody sandwich enzyme linked immunosorbent assay (Elisa).Results after 3 months of treatment, NIHSS Hamd scores were 1.77 卤0.58 and 5.43 卤1.77 in the intervention group, and 4.06 卤0.79 and 10.27 卤3.78 in the control group, respectively.The BI of the intervention group and the control group were 96.24 卤4.58 and 77.64 卤6.96, respectively, which were significantly higher than that of the incoming group, and the serum BDNF levels of the intervention group and the control group were 8.38 卤0.74 卤0.67 ng / mL, respectively, which were significantly higher than those of the control group, which were higher than that of the control group.There was no significant difference between the two groups (P 0.05).The incidence of PSD in the intervention group (10.0) was significantly lower than that in the control group (53.6%).Conclusion prophylactic use of antidepressants in patients with acute cerebral infarction can increase serum BDNF level and improve prognosis.
【作者单位】：江苏省连云港市第二人民医院神经心理科;
【基金】：江苏大学医学临床科技发展项目(JLY20140131)
【分类号】：R743.33

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