中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2010年
5期
355-357
,共3页
卢瑞春%苗丹%王昊%谭兰
盧瑞春%苗丹%王昊%譚蘭
로서춘%묘단%왕호%담란
卒中%抑郁%阿米替林%精神病状态评定量表%日常生活活动
卒中%抑鬱%阿米替林%精神病狀態評定量錶%日常生活活動
졸중%억욱%아미체림%정신병상태평정량표%일상생활활동
Stroke%Depression%Amitriptyline%Psychiatric status rating scales%Activities of daily living
目的 通过临床试验研究证实早期应用小剂量阿米替林对首发脑卒中后抑郁(PSD)的干预作用.方法 选取123例首发脑卒中患者并随机分为干预组和对照组.干预组连续1个月以上每晚口服小剂量(12.5 mg)阿米替林,对照组为空白对照.调查患者的入院时及1个月后的基本情况、抑郁状态、神经功能缺损状态和日常生活能力.结果 干预治疗后,阿米替林干预组PSD的患病率为16.4%(10/61),明显低于对照组的51.6%(32/62).干预治疗结束时,阿米替林干预组的NIHSS评分为2.83±1.74,低于对照组(3.64±1.93);而阿米替林干顶组的ADL评分为93.0±16.1,高于对照组的87.0±37.1.为排除混杂因索,多因素分析结果显示:ADL评分前后变化与首次脑卒中患者PSD患病率明显相关(RR=3.01,P=0.04);NIHSS评分前后变化与首次脑卒中患者PSD患病率明显相关(RR=2.42,P=0.03);是否应用小剂量阿米替林与首次脑卒中患者PSD患病率明显相关(RR=3.11,P=0.01).结论 给予小剂量阿米替林干预性治疗能降低首次脑卒中患者PSD的患病率,并且使其神经功能缺损降低,日常生活能力提高.
目的 通過臨床試驗研究證實早期應用小劑量阿米替林對首髮腦卒中後抑鬱(PSD)的榦預作用.方法 選取123例首髮腦卒中患者併隨機分為榦預組和對照組.榦預組連續1箇月以上每晚口服小劑量(12.5 mg)阿米替林,對照組為空白對照.調查患者的入院時及1箇月後的基本情況、抑鬱狀態、神經功能缺損狀態和日常生活能力.結果 榦預治療後,阿米替林榦預組PSD的患病率為16.4%(10/61),明顯低于對照組的51.6%(32/62).榦預治療結束時,阿米替林榦預組的NIHSS評分為2.83±1.74,低于對照組(3.64±1.93);而阿米替林榦頂組的ADL評分為93.0±16.1,高于對照組的87.0±37.1.為排除混雜因索,多因素分析結果顯示:ADL評分前後變化與首次腦卒中患者PSD患病率明顯相關(RR=3.01,P=0.04);NIHSS評分前後變化與首次腦卒中患者PSD患病率明顯相關(RR=2.42,P=0.03);是否應用小劑量阿米替林與首次腦卒中患者PSD患病率明顯相關(RR=3.11,P=0.01).結論 給予小劑量阿米替林榦預性治療能降低首次腦卒中患者PSD的患病率,併且使其神經功能缺損降低,日常生活能力提高.
목적 통과림상시험연구증실조기응용소제량아미체림대수발뇌졸중후억욱(PSD)적간예작용.방법 선취123례수발뇌졸중환자병수궤분위간예조화대조조.간예조련속1개월이상매만구복소제량(12.5 mg)아미체림,대조조위공백대조.조사환자적입원시급1개월후적기본정황、억욱상태、신경공능결손상태화일상생활능력.결과 간예치료후,아미체림간예조PSD적환병솔위16.4%(10/61),명현저우대조조적51.6%(32/62).간예치료결속시,아미체림간예조적NIHSS평분위2.83±1.74,저우대조조(3.64±1.93);이아미체림간정조적ADL평분위93.0±16.1,고우대조조적87.0±37.1.위배제혼잡인색,다인소분석결과현시:ADL평분전후변화여수차뇌졸중환자PSD환병솔명현상관(RR=3.01,P=0.04);NIHSS평분전후변화여수차뇌졸중환자PSD환병솔명현상관(RR=2.42,P=0.03);시부응용소제량아미체림여수차뇌졸중환자PSD환병솔명현상관(RR=3.11,P=0.01).결론 급여소제량아미체림간예성치료능강저수차뇌졸중환자PSD적환병솔,병차사기신경공능결손강저,일상생활능력제고.
Objective To test whether the prophylactic small dose amitriptyline has any beneficial influence on the rate of poststroke depression (PSD) by clinical experiment. Methods All 123 patients with first stroke were divided into the intervention group and the control group according to the block randomization tables. The patients in the intervention group were treated with 12. 5 mg amitriptyline every night for more than 1 month and the control group was blank Before and at the end of the observation, the rate of PSD and activities of daily living (ADL), degree of neurological deficit (NIHSS) of all the subjects were assessed. Results At the end of the one-month treatment, the intervention group had lower rate of PSD (16. 4% ) than the control (51.6%);and they had lower score in NIHSS (2. 83 ± 1.74 vs 3. 64 ±1.93) and higher score in ADL (93.0 ± 16. 1 vs 87.0 ± 37. 1) than the control. Multivariate Logistic regression analysis showed: the change of ADL score was closely related to the rate of PSD (RR =3.01 ,P =0. 04); the change of NIHSS score was closely related to the rate of PSD ( RR = 2. 42, P = 0. 03 );prophylactic small dose amitriptyline was closely related to PSD ( RR = 3.11, P = 0. 01 ). Conclusions Prophylactic small dose amitriptyline can decrease the rat of PSD, reduce the neurologic impairment and improve the activity of daily living.
