文拉法辛对急性和慢性期缺血性脑卒中患者抑郁障碍临床观察.docVIP

文拉法辛对急性和慢性期缺血性脑卒中患者抑郁障碍临床观察 　　[摘要] 目的 比较文拉法辛治疗脑卒中后急性和慢性期缺血性脑卒中患者抑郁障碍治疗的疗效。方法 选择2010―2013门诊及病房收治的脑梗死患者为观察对象。急性组为首次发病住院，脑卒中后即日至2个月的缺血性脑卒中患者60例，慢性组为脑卒中后3个月～1年的缺血性脑卒中患者60例，均符合中华医学会第四届全国脑血管会议修订的《脑血管病诊断要点》及《中国精神障碍诊断和分类标准（CCMD-3）》抑郁诊断标准，HAMD抑郁量表评分18分。观察疗程均为8周，定期对患者采用HAMD抑郁量表比较，采用χ2检验。结果 急性组临床疗效总有效率为90.0%，显著优于对照组的73.0%（P0.05）。两组治疗后HAMD评定，治疗第2周开始较治疗前有统计学意义，且一直持续至观察第8周，急性组较慢性组差异有统计学意义（P0.05）。结论 文拉法辛治疗脑卒中后抑郁急性较慢性期缺血性脑卒中患者抑郁障碍治疗疗效显著。 　　[关键词] 脑卒中后抑郁；急性和慢性期缺血性脑卒中患者抑郁障碍；文拉法辛 　　[中图分类号] R657.5 [文献标识码] A [文章编号] 1674-0742（2014）04（b）-0039-02 　　[Abstract] Objective To compare the therapeutic effect of venlafaxine on patients with depressive disorder （DD） after acute or chronic ischemic stroke. Methods The patients with cerebral infarction were selected from Department of Neurology and ward of The Peoples Hospital of Liaoning Province between 2010 and 2013. They were divided into acute group （60 patients， first episode with the course of disease was less than 2 months） and chronic group （60 patients with the disease course of 3-12 months after stroke）. The diagnosis of the patients conformed to Diagnostic Points for Cerebrovascular Disease and Chinese Classification and Diagnostic Criteria of Mental Disorders， Version Three （CCMD-3） revised by The Chinese Medical Association Fourth National Cerebrovascular Diseases Conference， with the scores of HAMD depression scale 18. All patients received the treatment of 8 weeks， and had regular evaluation with HAMD depression scale. X2-test was used in the comparison between the acute group and the chronic group. Results The clinical total effective rate was 90.0% in acute group， significantly higher than the control groups 73.0% （P0.05）. HAMD evaluation of two groups after treatment， treatment from the second week had statistical significance compared with pretreatment， and continued to the eighth week. There was statistical significance in acute group compared with chronic group （P0.05）. Conclusion Venlafaxine has significant curative eff