脑梗死后抑郁症状综合康复治疗的疗效及其对血小板5-羟色胺水平的影响

关键词：脑梗死 抑郁症状 5-羟色胺 心理治疗 帕罗西汀

Keywords:cerebral infarction  depressive symptom  serotonin  psychotherapy  paroxetine

摘要：

      目的：观察综合康复治疗（抗抑郁药物联合心理干预）对脑梗死后抑郁症状的临床疗效及对血小板5-羟色胺（5-HT）的影响。方法：66例脑梗死后抑郁症状患者随机分为两组，治疗组34例给予药物（帕罗西汀）联合心理干预治疗6周，对照组32例，未接受上述治疗，所有患者在治疗前后均进行Zung量表评分，HAMD评分，ADL评分及血小板5-羟色胺测定。结果：两组Zung量表、HAMD评分治疗后减分明显，ADL评分明显增加且有非常显著性差异（P〈0．01），治疗组ADL评分增加更明显，且有非常显著性差异（P〈0．01）。伴抑郁症状的脑梗死患者血小板5-HT含量较低．应用联合治疗后，脑梗死患者抑郁症状改善的有效率为70％以上，血小板5-HT含量进一步下降。结论：综合康复治疗对脑梗死后抑郁症状有较好的疗效。血小板5-HT含量可作为早期诊断抑郁症状的实验室筛查指标。

Abstract:

      Objective:To discuss the effect of combined therapy of anti-depression medicines and psychotherapy on the rehabilitation of the cerebral infarction patients with depressive symptom. And to observe its effect on platelet serotonin.Method: Sixty-six patients of cerebral infarction with depressive symptom were randomly divided into two groups. Thirty-four patients in treatment group were treated with paroxetine and psychotherapy for six weeks,32 patients in control group. All patients were measured with Zung?HAMD and ADL score and platelet 5-HT concentration before and after treatment.Result:After treatment,Zung scores and HAMD scores in these two groups were decreased significantly,ADL scores increased significantly(P<0.01). Patients in treatment group got statistically significant improvement in ADL scores(P<0.01).It was found that cerebral infarction patients with depressive symptoms had a lower level of platelet 5-HT concentration than normal(P<0.01). After six weeks of combined treatment,symptoms of depression were significantly better than before(P<0.01).The level of platelet 5-HT concentration after treatment was lower than before.Conclusion:It is suggested that combined rehabilitation treatment was an available therapy in cerebral infarction patients with depressive symptom. Platelet 5-HT concentration would be used as an early screening mark of patients with depressive symptom.