CAJ | 학술논문

目的：探讨卒中后抑郁的早期干预对急性脑梗死患者神经功能、生活质量恢复的影响。方法所选病例随机分为治疗组（舍曲林50 mg每晚）和对照组（淀粉片1＃每晚），两组均联合心理治疗，疗程12周，监测治疗前后血浆皮质醇（COR）水平，依据美国国立卫生研究院卒中量表（ NIHSS）、9条目病人健康问卷（PHQ-9）、汉密尔顿抑郁量表（HAMD）、日常生活能力量表（ADL）标准进行评分，评价急性期脑梗死抑郁患者早期干预疗效、神经功能的恢复及生活质量的改善及随访观察卒中后抑郁（PSD）的发生率。结果两组患者治疗有效率前后对比差异均具有统计学意义（P ＜0.05），尤以治疗组明显，治疗后治疗组与对照组对比差异有统计学意义（ P ＜0.05）；治疗后治疗组 NIHSS、HAMD评分及 COR水平均低于对照组；ADL评分高于对照组，PSD发生率明显低于对照组，差异均具有统计学意义（P ＜0.05）。结论卒中后抑郁的早期干预能促进患者神经功能恢复，提高生活质量，降低 COR水平和PSD发生率。应重视卒中后急性期内抑郁的早期筛查。
목적：탐토졸중후억욱적조기간예대급성뇌경사환자신경공능、생활질량회복적영향。방법소선병례수궤분위치료조（사곡림50 mg매만）화대조조（정분편1＃매만），량조균연합심리치료，료정12주，감측치료전후혈장피질순（COR）수평，의거미국국립위생연구원졸중량표（ NIHSS）、9조목병인건강문권（PHQ-9）、한밀이돈억욱량표（HAMD）、일상생활능역량표（ADL）표준진행평분，평개급성기뇌경사억욱환자조기간예료효、신경공능적회복급생활질량적개선급수방관찰졸중후억욱（PSD）적발생솔。결과량조환자치료유효솔전후대비차이균구유통계학의의（P ＜0.05），우이치료조명현，치료후치료조여대조조대비차이유통계학의의（ P ＜0.05）；치료후치료조 NIHSS、HAMD평분급 COR수평균저우대조조；ADL평분고우대조조，PSD발생솔명현저우대조조，차이균구유통계학의의（P ＜0.05）。결론졸중후억욱적조기간예능촉진환자신경공능회복，제고생활질량，강저 COR수평화PSD발생솔。응중시졸중후급성기내억욱적조기사사。
Objective To discuss the relationship between the early intervention of PSD,recovery of neurological deficits and life quality. Methods The selected cases were randomly divided into treatment group(with sertraline 50mg every night)and control group(pla-cebo 1# every night),both two groups received combined psychotherapy,and after 12 weeks of treatment,based on NIHSS,PHQ - 9, HAMD,ADL rating standards,the level of COR was monitored,the effect of early intervention in depression of patients with acute cerebral infarction was evaluated,the recovery of neural function,the improvement of the quality of life and the incidence of PSD were followed. Re-sults The treatment efficiency of two groups before and after treatment had significant difference (P < 0. 05),especially that of the treatment group was obvious,and the difference had statistical significance (P < 0. 05). After treatment,NIHSS,COR and HAMD in treatment group were all lower,ADL rating was higher,and the incidence of PSD was lower than those in control group,and the difference had statistical sig-nificance (P < 0. 05). Conclusion Conventional antidepressant and early psychological intervention in cerebral infarction patients with de-pression can promote nerve functional recovery in patients,improve the quality of life,and reduce the level of COR and the incidence of PSD. Attention should be paid to depression in acute cerebral infarction.