文拉法辛对卒中后抑郁患者认知功能改善的影响

摘要

Objective To observe the efficacy and safety of venlafaxine on cognitive function in patients with post stroke depres-sion(PSD) .Methods 72 patients of cognitive dysfunction with PSD were selected and randomly divided into observation group and control group with 36 cases in each .The control group was treated with therapy for acute stroke .The observation group was treated with venlafaxine based on the treatment of control group .After 12 weeks of treatment ,the mini mental state examination(MMSE) , the Montreal cognitive assessment scale(MoCA) and activities of daily living scale(ADL) were used to evaluated the efficacy of the two groups before ,fourth weeks after and twelfth weeks after the treatment .The scores of the two groups were compared .The oc-currence of adverse reaction of the observation group was recorded .Results After 4 weeks treatment of the observation group ,the MoCA was (18 .52 ± 4 .37) .MMSE score was (20 .61 ± 4 .85) ,which were significantly higher than before treatment .And the ADL score was (35 .27 ± 4 .75) ,significantly lower than before treatment(all P<0 .05) .After 12 weeks of treatment ,the MoCA score of observation group was (20 .14 ± 5 .26) .MMSE score was (22 .46 ± 4 .59) .Which were all significantly higher than those of control group .While the ADL score was (29 .85 ± 5 .07) ,significantly lower than the control group(all P<0 .05) .The observation group with 2 cases had mild gastrointestinal discomfort ,2 cases with dizziness .Conclusion Venlafaxine can improve cognitive function in patients with post stroke depression .It can significantly improve patients′self-care ability and is safe .It can be further applied in the clinic .%目的：观察文拉法辛对卒中后抑郁患者认知功能障碍的改善情况及其安全性。方法选取本院神经内科收治的卒中后抑郁并认知功能障碍的患者72例，按照随机数字表法将其分为观察组和对照组各36例。对照组按照急性脑卒中常规治疗方案进行治疗，观察组在对照组治疗方案的基础上，加用文拉法辛片口服。采用简易智能量表（MMSE）、蒙特利尔认知评估量表（MoCA）、日常生活活动能力量表（ADL）在治疗前、治疗第4周和治疗第12周对两组患者进行评估。用统计方法对比分析两组患者的量表评估结果。结果治疗4周后，观察组MoCA评分为（18．52±4．37）分，MMSE评分为（20．61±4．85）分，均显著高于治疗前，而ADL评分为（35．27±4．75）分，显著低于治疗前（P＜0．05）；治疗12周后，观察组MoCA 评分为（20．14±5．26）分， MMSE评分为（22．46±4．59）分，均显著高于对照组，而ADL评分为（29．85±5．07）分，显著低于对照组（P＜0．05）；观察组有2例出现轻度胃肠道不适，2例出现轻度头晕，未发生严重的不良反应事件。结论文拉法辛能够显著改善卒中后抑郁患者的认知功能，提高患者的自理能力，同时具有良好的安全性。