| Stroke included ischemic and hemorrhagic cerebrovascular disease,has a high incidence rate,high morbidity,high mortality,high recurrence rate and high economic burden " five high" characteristics.The stroke has become the first cause of death in our country,which is about 1 million 300 thousand of the patients died of cerebrovascular disease each year in China.Post-stroke depression and cognitive impairment are the important complications of cerebral apoplexy.In clinical practice,clinicians tend to pay less attention to the emotional and cognitive function of patients after stroke,resulting in lower diagnosis rate of depression and cognitive impairment after stroke.Post-stroke depression and cognitive impairment of complications after stroke significantly affected the prognosis and outcome of stroke patients,and less able to repair the nervous system,so the poor treatment of patients with post-stroke neurological defects,affecting their quality of life,resulting in prolonged hospitalization,increased health care costs,making families and society a heavy burden,stroke,cognitive impairment and mood disorders are frequently associated with and interact with each other,therefore they have been paid more and more attention.Recent studies have shown that antidepressant therapy can improve depressive symptoms,the cognitive function of the patients also recovered to a certain extent,at the same time,the change can further improve the neurological function and activities of daily living.Selective serotonin reuptake inhibitors(selective serotonin sites inhibitors(SSRIs)antidepressant escitalopram oxalate was widely used,currently used for antidepressant treatment and achieved good effect,used in the treatment of post-stroke cognitive impairment and neurological function recovery in terms of the effect is not very clear,this topic selection post stroke depression with recognition Patients with impaired cognition and impaired neurological function were studied.Objective:1 To observe the effect of early application of escitalopram oxalateon post stroke depression.2 To observe the effect of early application of escitalopram oxalateonon cognitive dysfunction after stroke.3 To observe the effect of early application of escitalopram oxalateon on cognitive dysfunction after stroke.Methods:Select from January 2014 to December 2015 in our hospital neurology admitted stroke patients,the diagnosis of ischemic stroke with reference to China with acute ischemic stroke treatment guidelines 2010 with acute cerebrovascular disease diagnostic criteria [1],hemorrhagic stroke diagnostic reference of 2010 promulgated the "adult diagnostic criteria for spontaneous intracerebral hemorrhage." [2],and in line with Chinese classification and diagnostic criteria of mental disorders diagnostic criteria for depression,not used any antidepressant therapy;Hamilton depression scale(HAMD)≥17 points,patients Mini-mental state Examination(MMSE)screening cognitive impairment after stroke,defining who score below the normal level(out of 30 points,illiteracy <17 points;primary <20 points;above the level of <24 min),the presence of cognitive impairment after stroke.Application of the United States National Institutes of Health Stroke Scale(NIHSS),Functional Independence Measure Scale(FIM)Evaluation of neurological deficits and activities of daily living patients.They were enrolled in 120 cases,including 112 cases of ischemic stroke patients,8 cases of hemorrhagic stroke patients.Were randomly divided into treatment group(60 cases)and control group(60 cases),both groups received conventional therapy,the treatment group added in the escitalopram oxalate tablets therapy,oral 10 mg per day after breakfast,once every 24 weeks,the control group added in the treatment of liver qi stagnation capsule,each 2 orally twice daily.Before treatment and 4 weeks of treatment,patients were assessed indicators after 24 weeks.We applied Hamilton Depression Scale(HAMD)depression status evaluated using the Mini-Mental State Examination(MMSE)patients with cognitive function evaluation,the application of the US National Institutes of Health Stroke Scale(NIHSS)neurological deficit situation evaluable patients,the use of function independence Rating scale(FIM)evaluation of the patient’s activities of daily living.SPSSl9.0 application software for statistical analysis,the results were analyzed.Results:1 120 cases of patients,oxalate escitalopram treatment group and the control group were no significant differences in age,sex and level of education.2 With before treatment,at four weeks oxalate escitalopram treatment group HAMD score that is reduced(P<0.05),statistically significant;the same period,the control group HAMD score decreased slightly,(P>0.05),no statistical significance;oxalate escitalopram treatment group HAMD score decreased significantly in the first 24 weeks,and there before treatment and four weeks of treatment more significant differences and differences,respectively(P<0.01),(P<0.05),were statistically significant;the same period,the control group HAMD scores also declined,with the differences before treatment and at four weeks compared with both(P<0.05),also statistically significant.3 Comparison with before treatment,at four weeks,oxalate escitalopram treatment group MMSE score was no significant increase;the control group MMSE scores were not significantly increased,there was no significant difference(P> 0.05),no statistically significance.In the first 24 weeks,oxalate escitalopram treatment group compared to MMSE scores were significantly increased(P<0.01)before treatment and with four weeks of treatment,a statistically significant;the same period,the control group MMSE score no significant increase compared with the no treatment and four weeks before significant difference(P> 0.05),not statistically significant.4 With before treatment,at four weeks,oxalate escitalopram treatment group NIHSS scores did not decrease significantly,FIM score no significant increase(P>0.05),no statistically significant;no control group was significantly lower NIHSS score,FIM score no significantly higher(P>0.05),no statistically significant.In the first 24 weeks,oxalate escitalopram treatment group NIHSS score was significantly reduced,FIM scores were significantly higher in comparison with the four weeks before treatment and a significant difference(P <0.01),with statistical significance;while the control group had no significant decrease in the NIHSS score,FIM score was no significant increase,showed no significant difference(P>0.05)with the before treatment and four weeks,was not statistically significant.Conclusion:1 Early application of SSRIs Escitalopram oxalate can improve the symptoms of depression after stroke.2 Early application SSRIs drug escitalopram oxalate can improve cognitive impairment after stroke.3 Early application SSRIS drug escitalopram oxalate can promote the recovery of neurological function after stroke to improve daily living. |
PDF Full Text Request