帕罗西汀联合心理治疗对脑梗塞后抑郁的疗效观察

帕罗西汀联合心理治疗对脑梗塞后抑郁的疗效观察

潘燕1*,张晓宁2**,任生生3

(新疆医科大学1第五附属医院神经内科,2第一附属医院神经内科,3第五附属医院老年科,新疆乌鲁木齐830011)

摘要:目的:观察帕罗西汀联合心理治疗对脑梗塞后抑郁及神经功能康复的影响。方法:随机将62例脑梗塞患者分为治疗组(帕罗西汀联合心理治疗)和对照组(帕罗西汀治疗),在治疗前和治疗4周后采用汉密顿抑郁量表(H AM D)评定抑郁障碍发生情况,神经功能缺损量表评定神经功能缺损程度。结果:治疗组治疗后H A M D评分(12.6?6.1)分,显著低于治疗前(25.3?11.2)分(P<0.01)及对照组(18.6?7.3)分(P<0.05),两组抑郁疗效有统计学差异(P<0.05);治疗组治疗后神经功能缺损程度评分(10.8?7.5)分,显著低于治疗前(24.9?7.5)分(P<0.05)及对照组(15.2?4.9)分(P<0.05),两组神经功能康复疗效经Ridit比较有统计学差异(P<

0.05)。结论:帕罗西汀联合心理治疗可明显改善脑梗塞后抑郁程度,并能促进神经功能康复。

关键词:脑梗塞后抑郁;帕罗西汀;心理治疗

中图分类号:R971;R743.33文献标识码:A文章编号:1009-5551(2008)09-1181-03

The effect of paroxetine joint psychological treatment for depression

after cerebral infarction

PAN Yan,ZHANG Xiao-ning,REN Sheng-sheng

(Dep ar tment of N eurology,Fif th Aff iliated H osp ital,X inj iang M edical Univ er sity,

Ur um qi830011,China)

Abstract:Objective:T o observe the effect of par oxetine joint psycho log ical treatment for depr ession after cerebral infarction and the r ecovery o f neurolo gical function.Methods:Sixty tw o patients w ere randomly divided into treatment gr oup(Parox etine joint psycholog ical treatment)and the co ntrol g roup(Paro xetine tr eatment).Before and after treatm ent of four weeks by H amilton Depressio n Scale(H AM D)patients w ere assessed the o ccurr ence o f depression by hamilton Depression scale(H AMD).Neurolog ical deficit Scale w as used to assess their neuro logical deficits.Results:The tr eatment gr oup after treatment H AMD score(12.6?6.1)points,significantly low er than befo re treatment(25.3?11.2)points(P<0.01)and the contr ol g roup(18.6?7.3)points(P<0.05),clinical depression has also significant difference(P< 0.05);The treatm ent group after treatment neurolog ical deficit score(10.8?7.5)points,sig nificantly low er than befo re treatm ent(24.9?7.5)points(P<0.05)and the control group(15.2?4.9)po ints(P <0.05),neuro logical rehabilitation of the tw o g roups com paring the Ridit had a significant difference(P <0.05).C onclusion:Par ox etine jo int psy cholog ical treatm ent can significantly im prov e the level o f de-pression after cerebral infarction,and prom ote neurolo gical rehabilitatio n.

Key words:the depr ession after cerebr al infarction;parox etine;psycholog ical treatm ent

脑梗塞后抑郁(PID)是脑血管疾病的常见并发症之一,占脑卒中患者的50%~60%[1],不仅给患者带来躯体和精神上的痛苦,同时给家庭和社会带来沉重的负担。早期积极治疗可以促进PID的康复。我们对2006年1月~2007年9月在我院神经内科及老年科住院治疗的62例脑梗塞患者使用帕罗西汀联合心理治疗,取得较好疗效,现报道如下。1资料和方法

1.1一般资料共62例脑梗塞患者,其中男性34例,女性28例,平均年龄(6

2.4?15.5)岁。脑卒中时间2~3周40例,1~4个月22例。所有患者均符合/1995年全国第四届脑血管病学术会议0制定

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新疆医科大学学报JOU R NA L OF XIN JIA NG M EDICAL U N IV ERSIT Y2008Sep.,31(9)

* **作者简介:潘燕(1975-),女,在读硕士研究生,住院医师,研究方向:脑血管疾病及神经心理学研究。通讯作者:张晓宁:博士,硕士生导师,主任医师,研究方向:脑血管疾病和遗传代谢病。