摘要
目的探讨预防性使用氟西汀对急性缺血性脑卒中患者的神经功能缺损、炎症指标中性粒细胞和淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平的影响。方法收集洛阳市第一人民医院159例急性缺血性脑卒中患者,随机分为治疗组81例和对照组78例,两组均给予常规治疗,治疗组同时给予持续90天的口服氟西汀治疗。分别比较两组在不同时期(入院时、治疗30天及90天)的美国国立卒中研究卫生院量表(National Stroke Study Health Center Scale,NIHSS)、Barthel指数及17项汉密顿抑郁量表(17 items of Hamilton Depression Scale,HAMD)评分差异;卒中后抑郁发生率;比较两组入院时和治疗30天的NLR、hs-CRP水平。结果治疗组NIHSS评分30天(4.41±2.85)分、90天(3.01±2.71)分,较对照组30天(5.50±3.85)分(P<0.05)、90天(4.18±3.51)分(P<0.05)显著降低;治疗组Barthel指数评分30天(72.96±20.96)分、90天(82.10±18.28)分,较对照组30天(65.90±22.87)分(P<0.05)、90天(75.00±20.34)分(P<0.05)显著升高;治疗组HAMD评分30天(6.61±5.21)分、90天(4.62±4.21),较对照组30天(8.46±6.26)分(P<0.05)、90天(9.05±7.12)分(P<0.05)显著降低;治疗组30天(P<0.05)、90天(P<0.05)卒中后抑郁发生率较对照组显著降低;治疗组30天NLR(P<0.05)、hs-CRP(P<0.05)水平较对照组显著降低。结论急性缺血性脑卒中患者预防性使用氟西汀能改善神经功能和降低炎症指标NLR及超敏C反应蛋白的水平,减轻炎症反应是其可能的作用机制之一。
Objective To investigate the effects of prophylactic fluoxetine on the neurological deficit and the neutrophil/lym⁃phocyte ratio of inflammatory markers in patients with acute ischemic stroke.NLR and hypersensitive C-reactive protein(hs-CRP)levels.Methods Totally 159 patients with acute ischemic stroke were randomly divided into the treatment group(n=81)and the control group(n=78).Both groups were given routine treatment,while the treatment group was given oral fluoxetine for 90 days.National Stroke Study Health Center Scale(NIHSS),Barthel Index and 17 items of Hamilton Depression Scale(HAMD)scores were compared between the two groups at different periods(admission,30 days and 90 days of treat⁃ment).The levels of NLR and hs-CRP were compared between the two groups at admission and 30 days after treatment.Results NIHSS scores in the treatment group(4.41±2.85)at day 30 and(3.01±2.71)at day 90 were higher than those in the control group(5.50±3.85)at day 30(P<0.05),90 days(4.18±3.51)(P<0.05)significantly decreased;Barthel index scores of the treatment group(72.96±20.96)at day 30 and 90 days(82.10±18.28)were higher than those of the control group(65.90±22.87)at day 30 and 90 days(75.00±20.34)(P<0.05)significantly increased;HAMD scores in the treat⁃ment group(6.61±5.21)at day 30 and(4.62±4.21)at day 90 were higher than those in the control group(8.46±6.26)at day 30(P<0.05)and(9.05±7.12)at day 90(P<0.05)significantly decreased;The incidence of post-stroke depression was significantly lower than that in the control group;The treatment group had 30 days NLR(P<0.05),hs-CRP(P<0.05)was significantly lower than the control group.Conclusion Preventive use of fluoxetine in patients with acute is⁃chemic stroke can improve neurological function and reduce the levels of inflammatory markers NLR and hs-CRP,and reduc⁃ing inflammatory response is one of the possible mechanisms.
作者
李慧
邢付强
石进峰
王新新
LI Hui;SHI Jin-feng;XING Fu-qiang;WANG Xin-xin(Department of Neurology,The First People’s Hospital of Luoyang,Luoyang,Henan 471000,China;Department of Neurology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2022年第15期22-25,共4页
Journal of Medical Forum
基金
洛阳市科技计划项目(210076A)。
