标题：氟西汀联合阿普唑仑治疗脑梗死恢复期患者疗效观察

      作者：林志业，王科，林佛财    惠州市第三人民医院神经内科二区，广东 惠州 516000

      卷次： 2022年33卷20期

      【摘要】 目的 观察氟西汀联合阿普唑仑治疗脑梗死恢复期患者的临床疗效。方法 选择2020年6月至2021年5月惠州市第三人民医院神经内科二区收治的80例脑梗死恢复期患者为研究对象，采用随机数表法均分为观察组和对照组各40例。对照组患者给予阿普唑仑治疗，观察组患者给予氟西汀联合阿普唑仑治疗。治疗8周，比较两组患者的治疗效果，治疗前后的认知功能[蒙特利尔认知评估量表(MoCA)]、日常生活能力[Barthel 指数量表(BI)评分]、生活质量[健康状况问卷调查表(SF-36)]和C反应蛋白(CRP)、神经元特异性烯醇化酶(NSE)水平，并统计两组患者的不良反应发生情况。结果 观察组患者的治疗总有效率为95.00%，明显高于对照组的77.50%，差异有统计学意义(P<0.05)；治疗后，两组患者的MoCA评分、BI评分均明显高于治疗前，且观察组患者分别为(21.31±3.11)分、(76.42±4.31)分，明显高于对照组的(17.34±2.87)分、(65.31±5.10)分，差异均有统计学意义(P<0.05)；治疗后，两组患者的CRP、NSE水平均降低，且观察组患者分别为(7.11±1.02) mg/L、(8.91±1.45) μg/L，明显低于对照组的(9.76±1.32) mg/L、(11.69±2.09) μg/L，差异均有统计学意义(P<0.05)；治疗后，两组患者的躯体功能、情感职能、社会功能、精神健康等评分均升高，且观察组患者分别为(73.31±4.12)分、(72.87±4.11)分、(74.12±5.11)分、(75.29±4.98)分，明显高于对照组的(64.31±3.71)分、(61.46±3.96)分、(66.34±4.98)分、(67.32±5.07)分，差异均有统计学意义(P<0.05)；观察组患者的总不良反应发生率为7.50%，略低于对照组的10.00%，但差异无统计学意义(P>0.05)。结论 氟西汀联合阿普唑仑治疗脑梗死恢复期患者能促进神经功能恢复，提高生活能力和生活质量，降低炎症水平，治疗效果显著且安全性较高。
      【关键词】 脑梗死；恢复期；氟西汀；阿普唑仑；神经功能；生活质量；C反应蛋白；不良反应
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2022）20—2625—04

Effect of fluoxetine combined with alprazolam in the treatment of convalescent patients with cerebral infarction.LIN Zhi-ye, WANG Ke, LIN Fu-cai.
The Second Department of Neurology, Huizhou Third People's Hospital, Huizhou516000, Guangdong, CHINA
【Abstract】 Objective To observe the clinical efficacy of fluoxetine combined with alprazolam in the treatmentof convalescent patients with cerebral infarction. Methods Eighty convalescent patients with cerebral infarction admit-ted to the Second Department of Neurology, Huizhou Third People's Hospital from June 2020 to May 2021 were selectedas the research objects. According to the random number table method, they were divided into an observation group anda control group, with 40 patients in each group. Patients in the control group were treated with alprazolam, and patientsin the observation group were treated with fluoxetine combined with alprazolam. After 8 weeks of treatment, therapeuticeffect, and the levels of cognitive function [Montreal Cognitive Assessment Scale (MoCA)], activities of daily living [Ba-sel index (Barthel Index)], quality of life [health status questionnaire (SF-36)], C-reactive protein (CRP) and neuron spe-cific enolase (NSE) before and after treatment were compared between the two groups, and the adverse reactions of thetwo groups were counted. Results The total effective rate in the observation group was 95.00%, which was significantlyhigher than 77.50% in the control group (P<0.05). After treatment, the score of MOCA and BI in the two groups were sig-nificantly higher than those before treatment, and those in the observation group were (21.31±3.11) points and (76.42±4.31) points, respectively, which were significantly higher than (17.34±2.87) points and (65.31±5.10) points in the controlgroup (P<0.05). After treatment, the levels of CRP and NSE in the two groups were decreased, and those in the observationgroup were (7.11±1.02) mg/L and (8.91±1.45) μg/L, respectively, which were significantly lower than (9.76±1.32) mg/Land (11.69±2.09) μg/L in the control group (P<0.05). After treatment, the scores of physical function, emotional function,social function and mental health of patients in the two groups were increased, and those in the observation group were(73.31±4.12) points, (72.87±4.11) points, (74.12±5.11) points, and (75.29±4.98) points, respectively, which were signifi-cantly higher than (64.31±3.71) points, (61.46±3.96) points, (66.34±4.98) points, and (67.32±5.07) points in the controlgroup (P<0.05). The total incidence of adverse reactions in the observation group was 7.50%, which was slightly lowerthan 10.00% in the control group, and the difference was not statistically significant (P>0.05). Conclusion Fluoxetinecombined with alprazolam in the treatment of convalescent patients with cerebral infarction can promote the recovery ofneurological function, improve the ability of life and quality of life, and reduce the level of inflammation, which has sig-nificant treatment effect and high safety.
      【Key words】 Cerebral infarction; Convalescence; Fluoxetine; Alprazolam; Neurological function; Quality of life;C-reactive protein; Adverse reaction