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目的:观察叶酸、维生素B12联合西酞普兰对卒中后抑郁高血浆同型半胱氨酸(Hcy)水平患者的治疗效果。方法:90例卒中后抑郁患者分为A、B两组各45例,均予缺血性脑卒中常规治疗,A组予西酞普兰片20 mg·d-1口服,B组在口服西酞普兰基础上加用叶酸5 mg·d-1及维生素B120.5 mg·d-1口服。检测患者治疗前及治疗12周后血浆Hcy水平,采用汉密尔顿抑郁量表(HAMD)评估患者的抑郁状况,采用临床神经功能缺损程度评分标准(CSS)评价患者神经功能状况。结果:治疗12周后,A组患者血浆Hcy水平无明显变化(P>0.05),B组患者血浆Hcy水平明显下降,两组患者HAMD及CSS评分均较治疗前下降,B组患者的HAMD及CSS评分显著低于A组(P<0.05)。结论:叶酸、维生素B12联合西酞普兰治疗卒中后抑郁高血浆Hcy水平者能够显著降低患者血浆Hcy水平,改善抑郁状况,促进神经功能的恢复,疗效优于单用西酞普兰。
Objective: To observe the effect of folic acid, vitamin B12 and citalopram on patients with post-stroke depression and high homocysteine (Hcy) levels. Methods: 90 patients with post-stroke depression were divided into A and B groups, 45 cases each, which were given conventional treatment of ischemic stroke. Group A received citalopram 20 mg · d-1 orally. Pullan based on the use of folic acid 5 mg · d-1 and vitamin B120.5 mg · d-1 orally. Plasma Hcy levels were measured before and 12 weeks after treatment. Depression was assessed by Hamilton Depression Rating Scale (HAMD), and neurological status was assessed by clinical neurological deficit score (CSS). Results: After 12 weeks of treatment, there was no significant change in plasma Hcy level in group A (P> 0.05). Plasma homocysteine levels in group B were significantly lower than those in group B. HAMD and CSS scores in both groups were significantly lower than those before treatment CSS score was significantly lower than the A group (P <0.05). Conclusion: Folic acid, vitamin B12 combined with citalopram in the treatment of post-stroke depression and high plasma Hcy levels can significantly reduce plasma Hcy levels, improve depression and promote neurological recovery, the effect is superior to citalopram alone.