Clinical Investigation In Post-Stroke Depression Patients Complicated With Different Internal Disease And Its Effect On The Rehabilitation Of Neural Function

Objective:(1)To investigate the morbidity and clinical features of PSD (post-stroke depression) patients complicated with internal disease ,and observe the effect of internal disease on the onset and prognosis of PSD patients.(2)To evaluate the efficacy of citalopram in these patients through a controlled clinical trial . At the same time ,combining with the scores of nervous functional deficiency and Barthel index,assess the influnce of citrlopram on the rehabilitation of neural function.Methods:226 patients with stroke who fulfilled the criteria of our study were enrolled and were divided into four groups according to different internal disease they complicated with : no internal disease group; diabetes group ; coronary cardiopathy group; diabetes + coronary cardiopathy group. All patients were tested with HAMD and 76 patients were selected out . Observe the different morbidity in different group. Thoses patients were divided into treat group(38 examples) and contrast group(38 examples) at random and treated separately with citalopram and oryzanol .In each group , HAMD, the scores of nervous functional deficiency and Barthel index were performed before and after drug therapy under the same condition ,the clinical outcome was measured.Results:There was marked differential between the internal disease group and no internal disease group (p<0.01). No difference was found between diabetes group and coronary cardiopathy group.The morbidity of diabetes + coronary cardiopathy group was higher than the others .(2)Citalopram was superior effective concerning the primary outcome criterion HAMD(decreased from22.5±2.3 to 8.7±1.7 in the citalopram groupand from21.9±3.2tol7.7±2.1in the contrast group p<0.05)There was evident differential between the scores of nervous functional deficiency or Barthel index of pretreatment and that of posttreatment in treatment group and the variation was different between both group .In addition, in treat group,the variation of the HAMD after treatment was positively correlated with the variation of the scores of nervous functional deficiency and Barthel index(γ=0.9997andγ=0.9960,p<0.01)Conclusion:The morbidity of PSD in group with internal disease is higher than the group without internal disease .Neverthless ,it has no relationship with the type of the internal disease ,but has positive relationship with the number of the internal disease . (2) Citalopram can improve the depression symptom and the tolerability of citalopram is excellent.(3)Citaloprom can lessen the neurological symptom of PSD patients and decrease the level of deformity.