帕罗西汀对卒中后早期抑郁的疗效及血清白细胞介素类的影响

帕罗西汀对卒中后早期抑郁的疗效及血清白细胞介素类的影响杨娟;赵晓晖;朱玉萍;白青科;陈娟;夏卫英;陈练军;林同顺
【期刊名称】《中国脑血管病杂志》
【年(卷),期】2011(8)5
【摘要】Objective To observe the effect of paroxetine on the levels of serum interleukin-1 beta (IL-1 β) and IL-6 in patients with early poststroke depression (PSD) and the degree of improvement of the depressive symptoms.Methods Two hundred twenty-three consecutive patients with stroke within 72 hours of symptom onset were included.A total of 42 patients with early PSD whose Hamilton Depression Scale (HAMD) score ≥ 8 within 72 hours of onset were selected.They were randomly allocated into paroxetine treatment group ( n = 20) and control group ( n = 22).The patients in the treatment group were treated with paroxetine 20 mg/d at the time point of 72 hours, and the cours e of treatment was ≥3 months.The other treatments were the same in both groups.The serum concentrations of IL-1 β and IL-6 at 72 hours, 1 and 3 months after onset, as well as the HAMD scores at all time points were compared.Results
①There was no difference in the HAMD scores between the 2 groups at 72 hours after onset.The HAMD score in the treatment group was lower than that in the control group at the same time period 1 and 3 months after treatment.There were significant difference (P ＜0.01 ).There was no significant difference in the HAMD scores between the 2 groups 1 and 3
months after treatment.②There was no significant difference in serum IL-1β and IL-6 at 72 hours after onset in both groups of patients.The IL-1β and IL-6 in the treatment group were lower than those in the control group at the same time 1 and 3 months after treatment.There were significant difference ( P ＜ 0.01 ).IL-1 β and IL-6 reached the peaks at 1 month after treatment in both groups, and began to decrease at 3 months, but the control group was still higher than the level at 72 hours ( P ＜
0.01 ), and the treatment group was decreased to the level at 72
hours.Conclusion The increased serum IL-1β and IL-6 concentrations may be ralated to the onset of patients with early PSD.Paroxetine may improve the depressive symptoms of patients by the interference of the serum IL-1 β and IL-6.%目的观察帕罗西汀对卒中后早期抑郁患者血清IL-1 β、IL-6水平的影响及对抑郁症状的改善情况.方法连续纳入发病 < 72 h的卒中患者223例,选择发病后 < 72 h、汉密尔顿抑郁量表(HAMD)评分≥8的卒中后早期抑郁(PSD)患者42例.将其随机分为帕罗西汀治疗组(简称治疗组)20例,对照组22例.治疗组在卒中后72 h时间点开始给予帕罗西汀20 mg/d,疗程≥3个月,其他治疗两组相同.比较两组发病后72 h,1、3个月时血清IL-1 β、IL-6的浓度,以及各时间点的HAMD 评分.结果①两组发病72 h时,HAMD评分差异无统计学意义;治疗1、3个月时,治疗组HAMD评分均低于同期对照组,差异有统计学意义(P<0.01);两组治疗后1个月与3个月HAMD评分比较,差异均无统计学意义.②发病72 h,两组IL-1β、IL-6差异均无统计学意义;治疗1、3个月,治疗组IL-1β及IL-6均低于同期对照组,差异有统计学意义(P<0.01);两组IL-1β、IL-6均在治疗后1个月时达高峰,3个月时下降,但对照组仍高于72 h时水平(P<0.01),治疗组则降至72 h时水平.结论血清IL-
1β、IL-6浓度升高可能参与卒中后早期抑郁患者的发病;帕罗西汀可能通过干预心血清IL-1β、IL-6,改善患者的抑郁症状.
【总页数】4页(P235-238)
【作者】杨娟;赵晓晖;朱玉萍;白青科;陈娟;夏卫英;陈练军;林同顺
【作者单位】201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科;201200,上海市浦东新区人民医院神经内科
【正文语种】中文
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