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目的观察氟西汀对卒中后抑郁(PSD)患者外周血外周型苯二氮卓受体(PBRs)及神经功能的影响。方法收集2005年12月至2008年3月山东大学附属省立医院神经内科收治的首次发病的脑梗死后抑郁患者86例,将其随机分为氟西汀组和对照组。氟西汀组给予氟西汀20 mg/d,连续服药4周;对照组给予茴拉西坦胶囊100 mg/d。采用改良的斯堪的那维亚神经功能缺损评分量表(SSS)评价神经功能。提取外周血血小板膜,应用放射配基[3H]PK11195结合试验测定PBRs特异结合活性。结果治疗前两组组间[3H]PK11195结合活性差异无统计学意义(t=1.089,P=0.279)。治疗后氟西汀组PBRs结合活性显著高于对照组(t=14.797,P<0.001),Hamilton抑郁量表(HAMD)评分(t=6.369,P<0.001)、SSS评分(t=2.897,P=0.005)显著低于对照组。患者血小板膜PBRs结合活性与HAMD评分(r=-0.303,P=0.006)及SSS评分均具有显著相关性(r=-0.255,P=0.019)。结论氟西汀能够增加PSD患者血小板膜PBRs结合活性,促进神经功能恢复。
Objective To observe the effect of fluoxetine on peripheral blood benzodiazepine receptor (PBRs) and neurological function in patients with post stroke depression (PSD). Methods Totally 86 patients with first-onset depression after cerebral infarction who were admitted to Department of Neurology, Provincial Hospital Affiliated to Shandong University from December 2005 to March 2008 were randomly divided into fluoxetine group and control group. The fluoxetine group was given fluoxetine 20 mg / d for 4 weeks and the control group was given aniracetam capsule 100 mg / d. Neurological function was assessed using the modified Scandinavian Neurological Deficit Rating Scale (SSS). Peripheral blood platelet membranes were extracted and specific binding activity of PBRs was determined using the radioligand binding assay [3H] PK11195. Results There was no significant difference in the binding activity of [3H] PK11195 between the two groups before treatment (t = 1.089, P = 0.279). PBRs binding activity in fluoxetine group was significantly higher than that in control group (t = 14.797, P <0.001), HAMD score (t = 6.369, P <0.001) and SSS score = 0.005) was significantly lower than the control group. The platelet membrane PBRs binding activity was significantly correlated with HAMD score (r = -0.303, P = 0.006) and SSS score (r = -0.255, P = 0.019). Conclusion Fluoxetine can increase the platelet PBRs binding activity in PSD patients and promote the recovery of neurological function.