首页|抑郁症状维度对高频重复经颅磁刺激联合氟哌噻吨美利曲辛片治疗脑卒中后抑郁症疗效的预测价值

抑郁症状维度对高频重复经颅磁刺激联合氟哌噻吨美利曲辛片治疗脑卒中后抑郁症疗效的预测价值

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目的 本研究旨在探究重复经颅磁刺激(rTMS)联合氟哌噻吨美利曲辛片对脑卒中后抑郁(PSD)的疗效,并评估抑郁症状维度对疗效的预测价值。方法 选取青岛市胶州中心医院康复医学科2021年1月至2023年12月诊治的PSD患者为研究对象,所有患者均给予rTMS联合氟哌噻吨美利曲辛片治疗。评估并比较治疗前后PSD患者美国国立卫生研究院卒中量表(NIHSS)、汉密尔顿抑郁量表(HAMD)和Barthel指数(BI)。根据治疗效果,将PSD患者分为有效组和无效组,采用Logistic回归探讨抑郁症状维度与治疗结局的关系。采用受试者工作曲线(ROC)探讨抑郁症状维度对PSD患者疗效预测价值。结果 研究共纳入PSD患者80例,其中治疗有效68例,治疗无效12例。与治疗前比较,PSD患者HAMD评分、NIHSS评分显著下降(P<0。05),BI评分显著上升(P<0。05)。有效组PSD患者可观察情绪(OM)评分、认知评分和神经营养症状(NS)评分高于无效组(P<0。05)。Logistic回归分析表明,高水平OM评分、认知评分和NS评分是PSD治疗有效的独立保护因素。ROC分析表明,基线OM评分、认知评分和 NS评分预测治疗无效效能分别为 0。744[95%CI(0。568,0。921)]、0。734[95%CI(0。572,0。896)]和0。709[95%CI(0。534,0。884)]。结论 rTMS联合氟哌噻吨美利曲辛片可显著改善PSD患者抑郁症症状和神经功能损伤,提升日常生活能力。此外,基线时抑郁症状维度可预测PSD患者治疗效果。
The prediction value of depressive symptom dimensions in the efficacy of high-frequency repetitive transcranial magnetic stimulation combined with flupentixol and melitracen tablets for post-stroke depression
Objective To explore the efficacy of repeated transcranial magnetic stimulation(rTMS)combined with flupentixol and melitracen tablets on post-stroke depression(PSD)and to evaluate the predictive value of depressive symptom dimensions on the efficacy.Methods PSD patients diagnosed and treated in the department of rehabilitation medicine of Jiaozhou Central Hospital of Qingdao from January 2021 to December 2023 were selected as the research subjects,all patients were treated with rTMS combined with flupentixol and melitracen tablets.The National Institutes of Health Stroke Scale(NIHSS),Hamilton Depression(HAMD),and Barthel Index(BI)of PSD patients before and after treatment were evaluated and compared.PSD patients were divided into the effective group and the ineffective group based on treatment effectiveness,and Logistic regression was used to explore the relationship between depression symptom dimensions and treatment outcomes.Using the receiver operating characteristic(ROC)curve to explore the predictive value of depression symptom dimensions on the efficacy of PSD patients.Results A total of 80 PSD patients were included in this study,of which 68 cases were effective in treatment and 12 cases were ineffective in treatment.Compared with before treatment,PSD patients showed a significant decrease in HAMD score,NIHSS score(P<0.05),and BI score was significant increased(P<0.05).The observed mood(OM)score,cognitive score,and neurological symptom(NS)score of PSD patients in the effective group were higher than those in the ineffective group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that high-level OM score,cognitive score,and NS score were independent protective factors for effective PSD treatment.ROC analysis showed that the baseline OM score,cognitive score,and NS score for ineffective treatment were 0.744[95%CI(0.568,0.921)],0.734[95%CI(0.572,0.896)],and 0.709[95%CI 0.534,0.884)],respectively.Conclusion rTMS combined with flupentixol and melitracen tablets can significantly improve depression symptoms and neurological impairment,and improve the ability of daily living.Moreover,depressive symptom dimensions at baseline can predict the treatment effects of PSD patients.

Depressive symptom dimensionRepeated transcranial magnetic stimulationFlupentixol and melitracen tabletsEfficacyPrediction

姜艳平、张瑞莲、薛程川、刘贤秀

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青岛市胶州中心医院康复医学科(山东青岛 266300)

青岛市胶州中心医院神经内科(山东青岛 266300)

抑郁症状维度 重复经颅磁刺激 氟哌噻吨美利曲辛片 疗效 预测

青岛市卫生科技计划项目

2019-WJZD117

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.27(6)