【作者】 何萍；

【导师】 许丽珍；

【作者基本信息】 苏州大学 ， 神经病学， 2004， 硕士

【摘要】 目的：1．观察卒中后抑郁的发生率以及氟西汀早期治疗对卒中后抑郁的干预作用及对神经功能康复的影响。2．探讨血小板和血浆中5-羟色胺的含量与卒中后抑郁的关系及氟西汀治疗对其影响。 方法：选取2003年9月-2004年2月住院的脑卒中患者66例，随机分为氟西汀治疗组和常规治疗组，常规治疗组仅给神经内科常规治疗，氟西汀治疗组在常规治疗一周后加用氟西汀口服四周。对两组病人均在病程的一周及五周时采用汉密尔顿抑郁量表(HAMD)、日常生活能力量表(ADL)、神经功能缺损评分标准(SSS)进行评定，同时采用高效液相色谱-荧光法检测血小板和血浆中5-羟色胺的含量。 结果：卒中后抑郁发生率为38.24％，治疗后氟西汀治疗组HAMD抑郁评分低于常规治疗组(P＜0.05)，两组患者SSS、ADL分值均有好转，在好转程度上，氟西汀治疗较常规治疗明显(P＜0.05)，卒中后抑郁患者血小板5-羟色胺的含量正常，氟西汀治疗四周后血小板5-羟色胺的含量较治疗前明显减低(P＜0.05)，常规治疗前后血小板5-羟色胺的含量无明显差异(P＞0.05)，两组治疗前后血浆5 -羟色胺无差异。氟西汀早期干预卒中后抑郁的临床及实验研究中文提要 结论:卒中急性期卒中后抑郁发生率高;早期应用氟西汀治疗可减轻PSD症状、促进神经功能康复;血浆5轻色胺检测结果无显著意义，PSD患者血小板5经色胺含量正常，氟西汀治疗可引起脑卒中患者血小板5轻色胺含量降低。更多还原

【Abstract】 Objective(1) Observing the prevalence of post-stroke depression (PSD) to find out whether or not early anti-depression treatment by fluoxetine can either intervene PSD or be any beneficial to the rehabilitation after stroke.(2) Researching the relationship between blood 5-HT concentration and PSD to find out the influence of fluoxetine on plasma and platelet 5-HT concentration.Methods66 patients who were stroke (2003.09-2004.02) were chosen and divided into fluoxetine treatment group and regular treatment group. The regular treatment group only received regular treatment, while the fluoxetine treatment group received four-week fluoxetine treatment after one week regular treatment. Patients were evaluated by HAMD, ADL and SSS at the 1st week and the 5th week after stroke. Meanwhile, plasma and platelet 5-HT concentrations were measured by high performance liquid chromatography fluorescence detector.ResultsThe prevalence of PSD after stroke is 38.24%. The fluoxetine treatment group is scored lower than regular treatment group in the HAMD scale after treatment (P<0.05). Although rehabilitation evaluated by SSS and ADL is found in both groups after 4-week treatment (P<0.05 ) , advantages of fluoxetine treatment can be observed (P<0.05 ) .Generally, the platelet 5-HT concentration of PSD patients is normal, fluoxetine reduced platelet 5-HT concentration after 4-week treatment (P<0.05 ) . No notable difference in platelet 5-HT value can be observed before and after regular treatment (P>0.05) . No notable change in plasma 5-HT concentration can be observed in both groups before and after treatment (P>0.05) . ConclusionPrevalence of PSD is often after acute stroke. Early treatment by fluoxetine can release the symptom of PSD and promote rehabilitation of PSD patients. The effect of plasma 5HT value is not clear. The platelet 5-HT concentration of PSD patients is normal; however, fluoxetine treatment can reduce the platelet 5-HT concentration of stroke patients.更多还原