CAJ | 학술논문

　　目的探讨高压氧对卒中后抑郁（PSD）患者5-羟色胺（5-HT）及去甲肾上腺素（NE）的影响及临床疗效。方法将90例PSD患者按随机数字表法分为治疗1组、治疗2组、对照组各30例，在常规治疗的基础上，治疗1组采用高压氧治疗，治疗2组采用高压氧加口服文拉法辛治疗，对照组口服文拉法辛治疗。观察各组治疗前后AHMD、MIESS和ADL评分变化，检测各组治疗前后血清5-HT、NE含量，并进行统计学分析。结果治疗后各组HAMD、MIESS评分均有下降，ADL评分均有提高（P＜0．05）；HAMD、MIESS评分下降程度、ADL评分提高程度，治疗2组＞治疗1组＞对照组，差异均有统计学意义（P＜0．01）；治疗后各组5-HT及NE均有提高（P＜0．05）；5-HT及NE升高程度，治疗2组＞治疗1组＞对照组，差异均有统计学意义（P＜0．01）。结论高压氧主要通过提高患者体内NE和5-HT神经递质的浓度来实现治疗PSD的目的，能够有效控制PSD症状，提高神经功能及日常生活能力。
　　목적탐토고압양대졸중후억욱（PSD）환자5-간색알（5-HT）급거갑신상선소（NE）적영향급림상료효。방법장90례PSD환자안수궤수자표법분위치료1조、치료2조、대조조각30례，재상규치료적기출상，치료1조채용고압양치료，치료2조채용고압양가구복문랍법신치료，대조조구복문랍법신치료。관찰각조치료전후AHMD、MIESS화ADL평분변화，검측각조치료전후혈청5-HT、NE함량，병진행통계학분석。결과치료후각조HAMD、MIESS평분균유하강，ADL평분균유제고（P＜0．05）；HAMD、MIESS평분하강정도、ADL평분제고정도，치료2조＞치료1조＞대조조，차이균유통계학의의（P＜0．01）；치료후각조5-HT급NE균유제고（P＜0．05）；5-HT급NE승고정도，치료2조＞치료1조＞대조조，차이균유통계학의의（P＜0．01）。결론고압양주요통과제고환자체내NE화5-HT신경체질적농도래실현치료PSD적목적，능구유효공제PSD증상，제고신경공능급일상생활능력。
Objective To investigate the clinical effect of hyperbaric oxygen on 5-HT and norepinephrine (NE) in patients with post-stroke depression (PSD).Methods Ninety PSD patients were randomly divided into 3 groups(treatment group 1,treatment group 2 and control group with 30 cases in each group).On the basis of conventional treatment,the treatment group 1 was given hyperbaric oxygen and treatment group 2 was given hyperbaric oxygen plus venlafaxine orally,while the control group was given venlafaxine orally .The changes of AHMD score,MIESS score and ADL score were observed and the serum contents of 5-HT and NE were detected before and after treatment in each group.The results were analyzed statistically .Results The scores of HAMD and MIESS in each group decreased after treatment,and the ADL scores increased(P<0.05).The decrease of HAMD and MIESS scores and the increase of ADL score in the treatment group 2 were the largest,which were the smallest in the control group (P<0.01);5-HT and NE of each group increased after treatment (P<0.05),the increase of 5-HT and NE was the largest in the treatment group 2,which was the smallest in the control group (P<0.01).Conclusion Hyperbaric oxygen can realize the purpose of the treatment of PSD patients mainly by improving the neurotransmitter concentrations of NE and 5-HT, which can effectively control the occurrence of PSD and improve the patients′neural function and ability of daily life .