Abstract:

Objective　To observe the therapeutic effect of escitalopram and repetitive transcranial magnetic stimulation for patients with post-stroke depression and the effect on their neurotransmitters. Methods　This was a prospective study. Ninety patients with post-stroke depression who were admitted to Department of Neurology, Shenmu Hospital, Northwest University from February 2023 to March 2024 were selected as the study objects, and were divided into a study group and a control group by the random number table method, with 49 cases in each group. There were 21 males and 18 females in the study group; they were (58.31±4.26) years old. There were 22 males and 17 females in the control group; they were (58.82±4.17) years old. The control group took escitalopram once per day, 10 mg per time; the study group took escitalopram and repetitive transcranial magnetic stimulation. Both groups were treated for 1 month. The treatment effective rates, scores of Hamilton Depression Rating Scale-17 (HAMD-17) and modified Barthel index, and levels of neurotransmitter and were compared between the two groups. The independent-sample t and χ² tests were used for the statistical analysis. Results　After one month's treatment, the total effective rate in the study group was higher than that in the control group [93.88% (46/49) vs. 79.59% (39/49)]; the scores of HAMD-17 and modified Barthel index in the study group were better than those in the control group (8.64±3.28 vs. 11.13±3.37 and 63.81±3.27 vs. 55.76±5.64); the levels of serotonin and norepinephrine in the study group were higher than those in the control group [(110.53±10.24) μg/L vs. (90.79±10.33) μg/L and (10.27±1.05) μg/L vs. (8.14±1.13) μg/L]; there were statistical differences in the above indicators between the two groups (all P<0.05). Conclusion　Escitalopram combined with repetitive transcranial magnetic stimulation for patients with post-stroke depression can improve the treatment effective rate and their depression, daily life ability, and levels of neurotransmitters.

Key words: Post-stroke depression,  , Escitalopram,  , Repetitive transcranial magnetic stimulation,  , Neurotransmitters

摘要：

目的　观察艾司西酞普兰和重复经颅磁刺激在卒中后抑郁患者中的治疗效果及其对神经递质的影响。方法　采用前瞻性研究方法，选取2023年2月至2024年3月于西北大学附属神木医院神经内科收治的90例卒中后抑郁患者作为研究对象，根据随机数字表法分为研究组和对照组。研究组中49例，男21例、女18例，年龄（58.31±4.26）岁，采用草酸艾司西酞普兰（1次/d，10 mg/次）联合重复经颅磁刺激（1次/d）治疗1个月。对照组中49例，男22例、女17例，年龄（58.82±4.17）岁，采用草酸艾司西酞普兰（1次/d，10 mg/次）治疗1个月。比较两组患者的治疗有效率及汉密尔顿抑郁量表-17（HAMD-17）评分、改良Barthel指数、神经递质水平。采用独立样本t检验、χ2检验进行统计比较。结果　治疗1个月后，研究组患者总有效率为93.88%（46/49），对照组为79.59%（39/49）；研究组患者的HAMD-17评分、改良Barthel指数分别为（8.64±3.28）分、（63.81±3.27）分，对照组分别为（11.13±3.37）分、（55.76±5.64）分；研究组5-羟色胺、去甲肾上腺素水平分别为（110.53±10.24）μg/L、（10.27±1.05）μg/L，对照组分别为（90.79±10.33）μg/L、（8.14±1.13）μg/L；以上指标两组比较，差异均有统计学意义（均P<0.05）。结论　艾司西酞普兰联合重复经颅磁刺激可以提高卒中后抑郁患者的治疗有效率，降低抑郁程度，提高生活能力和神经递质水平。

关键词: 卒中后抑郁,  ,  , 艾司西酞普兰,  ,  , 重复经颅磁刺激,  ,  , 神经递质