【摘要】 目的:比较盐酸舍曲林与阿米替林治疗脑卒中后抑郁的疗效、安全性及对血清细胞因子的影响。方法:92例脑卒中后抑郁患者随机均分为A组(盐酸舍曲林组)和B组(阿米替林组)。两组患者均给予降压、调脂、降糖、神经保护、脱水及相应的康复训练等常规治疗。在此基础上,A组患者给予盐酸舍曲林片,初始剂量50 mg、qd,晨起口服,2周内逐增为200 mg、qd;B组患者给予阿米替林片,初始剂量25 mg、bid,早晚口服,2周内逐增为100 mg、bid。两组患者疗程均为1个月。观察两组患者临床疗效,治疗前后白细胞介素6(IL-6)、IL-1β、肿瘤坏死因子α(TNF-α)水平及不良反应发生情况。结果:A组患者总有效率显著高于B组,两组比较差异有统计学意义(P<0.05)。治疗前两组患者IL-6、IL-1β、TNF-α水平比较,差异均无统计学意义(P>0.05);治疗后两组患者IL-6、IL-1β、TNF-α水平均显著低于同组治疗前,且A组低于B组,差异均有统计学意义(P<0.05)。A组患者不良反应发生率显著低于B组,差异有统计学意义(P<0.05)。结论:盐酸舍曲林治疗脑卒中后抑郁较阿米替林疗效更显著,且安全性较好。更多还原

【Abstract】 OBJECTIVE:To compare the therapeutic efficacy and safety of sertraline hydrochhride and amitriptyline in the treatment of depression after stroke and the effects of them on serum cytokine. METHODS:92 patients with depression after stroke were randomly divided into group A(sertraline group)and group B(amitriptyline group). Two groups were given conventional treatment,including lowering blood pressure and glucose,regulating blood lipid,neuroprotection,dehydration and rehabilitation training,etc. On this basis,group A was given Sertraline hydrochloride tablets with initial dose of 50 mg,once a day,orally in the morning;gradually increased to 200 mg within 2 weeks,once a day,orally in the morning. Group B was given Amitriptyline tablets with initial dose of 25 mg,twice a day,orally in the morning and evening;gradually increased to 100 mg,twice a day,orally in the morning and evening. They were treated for one month to observe the clinical efficacy of two groups,the levels of IL-6,IL-1β,TNF-α and ADR before and after treatment. RESULTS:The total effective rate of group A was significantly higher than that of group B,and there were statistically significant differences(P<0.05). There were no significant differences in IL-6,IL-1β and TNF-α between 2 groups before treatment(P>0.05). The levels of IL-6,IL-1β and TNF-α in 2 groups after treatment were all significantly lower than before,and in group A was lower than in group B;there was statistically significant difference(P<0.05).The incidence of ADR in group A was significant lower than in group B;there was statistically significant difference(P<0.05).CONCLUSIONS:Therapeutic efficacy of sertraline hydrochloride is better than amitriptyline in the treatment of depression after stroke,and has better safety.更多还原