目的 分析老年脑梗死后抑郁症(Patients with Post Cerebral Infarction Depression,PCID)患者应用阿戈美拉汀联合文拉法辛治疗的临床疗效.方法 方便选取2021年2月—2022年10月于邵武市立医院就诊的74例PCID患者为研究对象,按照随机数表法分为研究组与对照组,各37例.两组均采用脑梗死常规药物治疗及康复疗法,对照组在其基础上加用阿戈美拉汀治疗,研究组在常规基础上加用阿戈美拉汀联合文拉法辛治疗.比较治疗前后两组抑郁严重程度[汉密顿抑郁量表(Hamilton Depression Scale,HAMD)]、活动功能[改良Barthel指数(Modified Barthel Index,MBI)]、认知功能[Wisconsin卡片分类测验(Wisconsin Card Sorting Test,WCST)]、脑血流动力学指标[搏动指数(Pulse Index,PI)、阻力指数(Resistance Index,RI)]水平变化,分析治疗后两组药物不良反应发生率.结果 治疗后,研究组HAMD评分、大脑中动脉RI水平及WCST评分中的持续应答数、错误应答数、持续性错误应答数、非持续性错误应答数分别为(15.34±2.56)分、(0.45±0.11)、(15.05±1.50)个、(30.05±3.21)个、(15.35±2.21)个、(18.55±3.56)个均低于同期对照组的(20.65±3.12)分、(0.55±0.12)、(18.56±1.32)个、(33.69±3.22)个、(18.26±2.98)个、(20.33±3.10)个,差异有统计学意义(t=8.003、3.737、10.685、4.870、4.771、2.294,P均＜0.05);治疗后,研究组大脑中动脉PI水平值、MBI及WCST评分中的完成分类数和正确应答数分别为(0.89±0.11)、(76.28±4.98)分、(10.34±2.41)个、(69.98±6.70)个均高于同期对照组的(0.84±0.09)、(70.39±4.87)分、(7.36±1.98)个、(63.28±4.60)个,差异有统计学意义(t=2.140、5.144、5.812、5.015,P均＜0.05).治疗期间,研究组总不良反应率为13.5%,与对照组的5.4%比较,差异无统计学意义(P＞0.05).结论阿戈美拉汀联合文拉法辛能有效减轻老年PCID患者抑郁严重程度,并改善脑部血流及活动功能、认知功能,疗法有效性及安全性俱佳.
Clinical Effect of Agomelatine Combined with Venlafaxine in the Treat-ment of Depression after Cerebral Infarction in the Elderly
Objective To analyze the clinical efficacy of agomelatine combined with venlafaxine in elderly patients with post cerebral infarction depression(PCID).Methods A total of 74 patients with PCID who were treated in Shaowu Municipal Hospital from February 2021 to October 2022 were conveniently selected as the study objects,and were di-vided into study group and control group according to random number table method,with 37 cases in each group.Both groups received conventional drug treatment and rehabilitation therapy for cerebral infarction,while the control group was treated with agomelatine on the basis of the treatment.The study group was treated with Agomelatine combined with venlafaxine on a routine basis.Compared the two groups before and after the treatment of Depression severity[Hamilton Depression Scale(HAMD)],activity function[Modified Barthel Index(MBI)],cognitive function[Wisconsin Card Sorting Test(WCST)],cerebral hemodynamic indicators[pulse index(PI)and resistance index(RI)]levels were changed to analyze the incidence of adverse drug reactions in the two groups after treatment.Results After treatment,the HAMD score,middle cerebral artery RI level,and the number of sustained responses,false responses,sustained false responses,and non-sustained false responses in WCST score of the study group showed(15.34±2.56)points,(0.45±0.11),(15.05±1.50)pieces,(30.05±3.21)pieces,(15.35±2.21)pieces,and(18.55±3.56)pieces,respectively,which were lower than those of the control group at the same period(20.65±3.12)points,(0.55±0.12),(18.56±1.32)pieces,(33.69±3.22)pieces,(18.26±2.98)pieces,and(20.33±3.10)pieces,and the differences were statistically sig-nificant(t=8.003,3.737,10.685,4.870,4.771,2.294,all P＜0.05).After treatment,the PI level values of the middle cerebral artery in the study group,as well as the number of completed classifications and correct responses in MBI and WCST scores,were(0.89±0.11),(76.28±4.98)points,(10.34±2.41)pieces,and(69.98±6.70)pieces,respectively,higher than those in the control group during the same period(0.84±0.09),(70.39±4.87)points,(7.36±1.98)pieces,and(63.28±4.60)pieces,and the differences were statistically significant(t=2.140,5.144,5.812,5.015,all P＜0.05).During the treatment period,the total adverse reaction rate in the study group was 13.5%,compared with 5.4%in the control group,the difference was not statistically significant(P＞0.05).Conclusion Agomelatine combined with Venla-faxine can effectively reduce the severity of depression in elderly patients with PCID,and improve cerebral blood flow,motor function and cognitive function.The therapy is both effective and safe.
AgomelatineVenlafaxineDepression after cerebral infarction
万方数据
维普
