艾地苯醌联合舍曲林治疗老年脑卒中后抑郁的疗效及对认知功能和氧化应激的影响

潘飞; 许彤; 张景丹; 赵峥; 李亚迪; 徐亚南; 徐亚辉

doi:10.16766/j.cnki.issn.1674-4152.003872

艾地苯醌联合舍曲林治疗老年脑卒中后抑郁的疗效及对认知功能和氧化应激的影响

doi: 10.16766/j.cnki.issn.1674-4152.003872

潘飞^1, ,,
许彤²,
张景丹³,
赵峥¹,
李亚迪⁴,
徐亚南⁵,
徐亚辉⁶

1.
新乡医学院第二附属医院精神四科，河南新乡 453000
2.
新乡医学院第二附属医院心境障碍二科
3.
新乡医学院第二附属医院早期干预二科
4.
新乡医学院第二附属医院儿童少年精神科
5.
新乡医学院第二附属医院老年精神科
6.
新乡医学院第二附属医院睡眠科

基金项目:

河南省医学科技攻关计划(联合共建)项目 LHGJ20190481

详细信息

通讯作者:
潘飞，E-mail: jjoo3636@163.com

中图分类号: R743 R749.4
计量
- 文章访问数: 8
- HTML全文浏览量: 5
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-08-11
- 网络出版日期: 2025-03-27

To investigate the efficacy of idebenone combined with sertraline in the treatment of elderly patients with post-stroke depression, and its effect on cognitive function and oxidative stress

PAN Fei^{1
, ,},
XU Tong²,
ZHANG Jingdan³,
ZHAO Zheng¹,
LI Yadi⁴,
XU Yanan⁵,
XU Yahui⁶

1.
Fourth Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan 453000, China

摘要

摘要: 目的探讨老年脑卒中后抑郁(PSD)患者采用艾地苯醌联合舍曲林治疗的效果, 并分析其对认知功能及氧化应激的影响。方法选取2021年6月-2023年6月新乡医学院第二附属医院收治的104例老年PSD患者, 采用随机数字表法分为对照组和研究组, 每组各52例, 分别接受舍曲林、艾地苯醌联合舍曲林治疗, 疗程为8周。观察2组治疗前和治疗4、8周的汉密尔顿抑郁量表(HAMD)评分变化, 评估临床疗效及治疗前后的认知功能[简易智力状态检查量表(MMSE)、韦氏成人记忆量表(WMS-RC)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)]及安全性。结果 2组HAMD评分比较组间效应、时间效应及交互效应均有统计学意义(P < 0.05), 治疗4、8周后研究组HAMD评分低于对照组, 且研究组HAMD评分随时间延长降低趋势更为明显; 研究组临床总有效率为96.15%(50例), 高于对照组的82.69%(43例, χ²=4.981, P=0.026);与治疗前比较, 2组治疗后MMSE评分、长时记忆、短时记忆、即刻记忆、记忆商数、血清SOD及GSH-PX活性均升高, 且研究组上述指标更高(P < 0.05);治疗后2组MDA水平与治疗前比较均降低, 且研究组更低(P < 0.05);研究组不良反应发生率为9.61%(5例), 与对照组(5.77%, 3例)比较差异无统计学意义(P>0.05)。结论老年PSD患者应用艾地苯醌联合舍曲林有助于减轻抑郁症状, 提高临床疗效, 改善认知功能, 减轻氧化应激损伤, 安全可靠。
- 脑卒中 /
- 抑郁症 /
- 艾地苯醌 /
- 认知功能 /
- 氧化应激 /
- 老年
Abstract: Objective To investigate the efficacy of idebenone combined with sertraline in elderly patients with post-stroke depression (PSD), and to analyze its effect on cognitive function and oxidative stress. Methods A total of 104 cases elderly patients with PSD were Seleeted and divided into a control group and study group, 52 cases in each group, and were treated with sertraline, edbenquinone combined with sertraline for 8 weeks, respectively.The Hamilton depression scale (HAMD) scores of the two groups were observed before treatment, 4 and 8 weeks after treatment.The clinical efficacy, cognitive function[mini-mental state examination (MMSE), Webster's adult memory scale (WMS-RC)], oxidative stress index[superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, glutathione peroxidase (GSH-PX) activity]before and after treatment and safety were evaluated. Results After 4 and 8 weeks of treatment, the inter-group effect, time effect, and interaction effect were significant (P < 0.05).The HAMD score of the study group was lower than that of the control group after 4 and 8 weeks of treatment, and the HAMD score of the study group had a more obvious decreasing trend with the extension of time.The total clinical effective rate was 96.15%(50 cases) in the study group and 82.69%(43 cases) in the control group, and the study group was higher than the control group (χ²=4.981, P=0.026).Compared with before treatment, MMSE scores, long-term memory, short-term memory, immediate memory, memory quotient, serum SOD and GSH-PX activities were increased in both groups after treatment, and higher in the study group (P < 0.05).The MDA levels in the 2 groups after treatment were decreased compared with before treatment, especially in the study group (P < 0.05).There was no significant difference in the incidence of adverse reactions between the study group (9.61%, 5 cases) and the control group (5.77%, 3 cases, P>0.05). Conclusion The use of idbenquinone combined with sertraline in elderly PSD patients is safe and reliable in alleviating depressive symptoms, improving clinical efficacy, improving cognitive function, and alleviating oxidative stress damage.
- Stroke /
- Depression /
- Idebenquinone /
- Cognitive function /
- Oxidative stress /
- Senility

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表 1 2组老年PSD患者基线资料比较

Table 1. Comparison of baseline data of 2 groups of elderly patients with PSD

组别	例数	年龄 (x±s，岁)	性别[例(%)]		脑卒中病程 (x±s，周)	脑卒中类型[例(%)]
组别	例数	年龄 (x±s，岁)	男性	女性	脑卒中病程 (x±s，周)	脑梗死	脑缺血
研究组	52	68.83±3.25	29(55.77)	23(44.23)	13.23±2.17	19(36.54)	33(63.46)
对照组	52	69.59±4.26	27(51.92)	25(48.08)	12.69±3.21	28(53.85)	24(46.15)
统计量		1.830^a	0.155^b		1.005^a	3.144^b
P值		0.070	0.694		0.317	0.076
注：^a为t值，^b为χ²值。

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表 2 2组老年PSD患者HAMD评分比较(x±s，分)

Table 2. Comparison of HAMD scores in two groups of elderly patients with PSD(x±s, points)

组别	例数	HAMD评分			F值	P值
组别	例数	治疗前	治疗4周	治疗8周	F值	P值
研究组	52	21.75±6.23	13.91±3.62^a	10.82±2.37^ab	20.150	< 0.001
对照组	52	21.69±6.84	15.69±3.71^a	12.48±2.97^ab	49.147	< 0.001
F值		0.047	2.476	3.150
P值		0.963	0.015	0.002
注：与本组治疗前比较，^aP＜0.05；与同组治疗4周比较，^bP＜0.05。

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表 3 2组老年PSD患者临床总有效率比较[例(%)]

Table 3. Comparison of the overall clinical effectiveness rate between two groups of elderly patients with PSD[cases (%)]

组别	例数	痊愈	显效	有效	无效	总有效
研究组	52	20(38.46)	17(32.69)	13(25.00)	2(3.85)	50(96.15)
对照组	52	17(32.69)	12(23.08)	14(26.92)	9(17.31)	43(82.69)
注：2组总有效率比较，χ²=4.981，P=0.026。

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表 4 2组老年PSD患者MMSE评分比较(x±s，分)

Table 4. Comparison of MMSE scores in 2 groups of elderly PSD patients(x±s, points)

组别	例数	MMSE评分		t值	P值
组别	例数	治疗前	治疗后	t值	P值
研究组	52	15.63±4.13	28.56±5.23	13.991	< 0.001
对照组	52	15.56±4.18	24.23±5.02	9.571	< 0.001
统计量		0.086^a	2.246^b
P值		0.932	0.035
注：^a为t值，^b为F值。

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表 5 2组老年PSD患者WMS-RC评分比较(x±s，分)

Table 5. Comparison of WMS-RC scores in 2 groups of elderly PSD patients(x±s, points)

组别	例数	长时记忆		短时记忆		即刻记忆		记忆商数
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	52	15.52±2.12	30.58±2.13^b	25.75±5.62	51.23±5.23^b	3.35±1.23	10.26±1.28^b	52.36±5.63	85.23±5.81^b
对照组	52	15.23±2.64	25.46±2.32^b	25.79±5.57	41.62±3.89^b	3.56±1.36	8.12±1.07^b	52.89±5.13	72.56±5.49^b
统计量		0.021^a	8.371^c	0.036^a	7.222^c	0.826^a	6.354^c	0.502^a	1.154^c
P值		0.983	< 0.001	0.971	< 0.001	0.411	< 0.001	0.617	0.261
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 6 2组老年PSD患者血清SOD、MDA和GSH-PX水平比较(x±s)

Table 6. Comparison of serum levels of SOD, MDA and GSH-PX in 2 groups of elderly patients with PSD(x±s)

组别	例数	SOD(U/mL)		MDA(μmol/L)		GSH-PX(U/mol)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
研究组	52	71.86±9.42	87.57±10.22^b	8.23±1.06	6.17±0.88^b	76.59±9.27	93.65±11.87^b
对照组	52	72.16±8.66	81.13±10.56^b	8.25±0.98	7.21±1.09^b	76.73±9.28	86.43±11.28^b
统计量		0.169^a	2.864^c	0.100^a	3.994^c	0.077^a	2.954^c
P值		0.866	0.013	0.921	0.001	0.939	0.009
注：^a为t值，^c为F值。与同组治疗前比较，^bP＜0.05。

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表 7 2组老年PSD患者不良反应发生率比较[例(%)]

Table 7. Comparison of the incidence of adverse reactions in two groups of elderly patients with PSD[cases (%)]

组别	例数	恶心	嗜睡	失眠	便秘	总发生
研究组	52	2(3.85)	1(1.92)	1(1.92)	1(1.92)	5(9.61)
对照组	52	2(3.85)	1(1.92)	0	0	3(5.77)
注：2组不良反应总发生率比较，χ²=0.542，P=0.462。

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