李 楠 张 续 杨 洋
郑州大学第二附属医院，河南 郑州 450003
【摘要】 目的 观察草酸艾司西酞普兰治疗卒中后抑郁（PSD）的疗效及对血清 S100β、NSE 水平的影响。方法 前瞻性纳入郑州大学第二附属医院神经内科于 2021-01—08 收治的 54 例PSD 患者，按随机数字表法分为对照组 27 例及观察组 27 例，对照组服用舍曲林片，观察组服用草酸艾司西酞普兰片，连续治疗 8 周。治疗前后检测血清中枢神经特异蛋白（S100β），神经元特异性烯醇化酶（NSE）水平，并采用 HAMD 评估抑郁程度。结果 2 组治疗后总有效率相比，差异无统计学意义（ χ2=0.220，P=0.639）。治疗后观察组HAMD 评分与对照组相比，差异无统计学意义（t=0.664，P=0.510）；观察组血清 S100β、NSE 水平较对照组显著降低，差异有统计学意义（t=2.821，P=0.007；t=2.545，P=0.014）。结论 草酸艾司西酞普兰和舍曲林治疗PSD 具有良好的疗效及安全性，且草酸艾司西酞普兰对 PSD 患者血清中S100β、NSE 水平的改善效果更好，血清S100β、NSE 水平可能有助于判断患者预后。
【中图分类号】 R749.1+3 【文献标识码】 A 【文章编号】 1673-5110 （2021） 24-2136-09
LI Nan，ZHANG Xu，YANG Yang
The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450003, China
【Abstract】 Objective To observe the efficacy of escitalopram oxalate in the treatment of post-stroke de⁃ pression（PSD） and its effect on serum S100 β and NSE levels. Methods A total of 54 patients with PSD who were admitted to the Department of Neurology in our hospital from January 2021 to August 2021 were prospectively selected. According to the random number table method, the control group（n=27） and the observation group（n= 27）, the control group took sertra Lin tablets, the observation group took escitalopram oxalate tablets, continuous treatment for 8 weeks. Serum central nervous system specific protein（S100β）and neuron specific enolase（NSE） levels were detected before and after treatment, and the degree of depression was assessed by HAMD. Results There was no significant difference in the total effective rate between the two groups after treatmen（t χ2=0.220，P=0.639）. There was no significant difference in the HAMD score between the observation group and the control group after treatment（t=0.664，P=0.510）. The levels of serum S100β and NSE in the group were significantly lower than those in the control group, and the difference was statistically significant（t=2.821，P=0.007；t=2.545，P= 0.014）. Conclusion Escitalopram oxalate and sertraline have good efficacy and safety in the treatment of PSD, and escitalopram oxalate has better improvement effect on serum S100β and NSE levels in patients with PSD. Serum S100β and NSE levels may help to determine the prognosis of patients.
【Key words】 Post-stroke depression; Escitalopram oxalate; CNS-specific protein（S100 β）; Neuron-specific enolase（NSE）