阿立哌唑治疗脑卒中后抑郁的疗效及其对事件相关电位P300的影响

摘要

目的探讨阿立哌唑治疗脑卒中后抑郁的疗效及其对事件相关电位P300的影响.方法 将64例脑卒中后抑郁患者随机分为观察组与对照组,每组32例,两组患者均予常规活血化瘀等对症支持治疗,其中观察组给予口服阿立哌唑5～15 mg/d,对照组口服奋乃静4～20 mg/d.治疗期间禁用其他的抗精神病药,疗程均为8周.比较两组的疗效及事件相关电位P300的潜伏期和波幅变化.结果 治疗第8周末,观察组32例患者中痊愈13例,显著进步7例,好转8例,无效4例;对照组32例患者中痊愈7例,显著进步5例,好转7例,无效13例,两组患者的疗效间差异有统计学意义(u=2.42,P ＜0.05).治疗第8周末,观察组和对照组的P300潜伏期[分别为(348.9±16.5) ms和(357.3±14.5) ms]、波幅[分别为(7.9±2.4) μV和(6.7±2.0) μV]比较,差异均有统计学意义( P ＜0.05).治疗第8周末,观察组的HAMD评分为(13.9±3.2)分,对照组为(17.2±4.7)分,差异有统计学意义( P ＜0.05).结论 阿立哌唑治疗脑卒中后抑郁的疗效优于奋乃静,可以降低HAMD评分,降低P300潜伏期,提高P300波幅.%Objective To explore the curative effect of aripiprazole on depression after stroke and compare it with per-phenazine.Methods A total of 64 cases of depression after stroke were randomized into observation groups and control group, 32 cases each.Both groups received supportive treatment routinely, with oral administered aripiprazole 5～ 15mg/d for the observation group and perphenazine 4 ～ 20mg/d for the control group.No other antipsychotic drugs were used during the 8 - week treatmeng.Curative effect and variation in latent period and amplitude of event related potential P300 of the two groups were compared.Results Of the 32 patients in the observation group, 13 were cured, 7 had been largely improved, 8 showed improvement , 4 showed no response by the end of 8th week; of the 32 patients in the control group 7 were cured, 5 had been largely improved, 7 showed improvement, 13 showed no response by the end of 8th week.Curative effects between the two groups showed statistically significant differences ( u = 2.42, P ＜ 0.05 ).Latent period length [( 348.9 ± 16.5 ) ms vs.( 357.3 ± 1.45 ) ms]and amplitude [( 7.9 ± 2.4 ) μV vs.( 6.7 ± 2.0 ) μV J of P300 showed significant difference between the observation group and the control group by the end of 8th week ( P ＜ 0.05 ).HAMD score for the observation group and the control group were ( 13.9 ± 3.2 ) and ( 17.2 ±4.7 ) respectively by the end of 8th week ( P ＜0.05 ).Conclusion Aripiprazole is more effective in treatment of depression after stroke than perphenazine.