目的 分析脑梗死抑郁应用盐酸氟西汀的治疗效果.方法 随机选择于2013年6月~2015年5月本院收治的脑梗死抑郁患者80例作为本研究对象,采用电脑随机分组方式将此次收治于本院的患者随机分为研究组与常规组,2组各40例;其中常规组患者给予神经内科常规治疗方案;研究组患者给予神经内科常规治疗加盐酸氟西汀治疗方案,使用神经功能缺损评分量表、HAMD(汉密尔顿抑郁)量表评价患者神经功能恢复情况以及抑郁改善状况,并观察2组患者用药的不良反应.结果 研究组患者神经功能恢复总效率达到85%、抑郁恢复达到70%;常规组患者神经功能恢复总效率达到了67.5%、抑郁恢复达到45%;研究组的治疗效果显著优于常规组(P<0.05).结论 针对脑梗死抑郁患者予以盐酸氟西汀进行治疗,其临床效果十分显著,疗效满意,即可显著改善患者抑郁状态,提升患者生活质量以及生活活动能力.

目的：观察氟西汀对脑梗死患者治疗1年内不同时期运动功能及认知功能障碍的影响。方法选取发病72 h内住院的急性脑梗死患者230例，随机分为治疗组及对照组，治疗组在住院48 h内常规二级预防的基础上加用氟西汀治疗，观察时间1年。截取住院48 h内，即氟西汀治疗前、脑梗死后1 w、1个月、3个月、1年5个时间点分别对两组患者进行NIHSS及MoCA量表检测及一般情况评定，并进行比较。同时比较1年内两组患者脑梗死复发情况。结果脑卒中后3个月、1年MoCA评分两组比较有统计学差异（ P＜0.05），1 w、1个月MoCA 评分两组比较无明显统计学差异（P＞0.05）。脑卒中后3个月，1年治疗组NIHSS评分与对照组比较具有明显的统计学意义（P＜0.001），脑卒中后1 w、1个月 NIHSS评分两组比较无明显统计学差异。结论氟西汀治疗能显著改善脑梗死后1年的运动功能及认知功能。

Objective To explore the impact of depressive disorders on early progressive motor deficits among patients with cerebral infarcts of basal ganglia region.Methods Eighty-five patients with first cerebral infarcts in basal ganglia region were enrolled into this study.All patients were examined with brain magnetic resonance imaging(MRI),magnetic resonance angiography(MRA) and diffusion weighted imaging(DWI).According to the Hamilton Depression Rating Scale scores on admission,patients were divided into non-depressive disorders group and depressive disorders group.Based on NIHSS scores of early progressive motor deficits,each above-mentioned group was further divided into stable subgroup and progressive subgroup.The occurrence rate of early progressive motor deficits,front-to-back ratio of volume of lesions(V2/V1),pathological changes in the middle cerebral artery(MCA),blood pressure,blood lipids and fasting blood glucose were compared between non-depressive disorders and depressive disorders groups.Results The occurrence rate of early progressive motor deficits in depressive disorders group was significantly higher than that of non-depressive disorders group(10/27,37.04% vs 9/58,15.52%,χ2=4.92,P=0.03).MCAs were obviously stenosing or occlusive(37/85,43.53%) in cerebral infarcts of basal ganglia region,but no statistically significant difference was found in the pathological changes in the MCA between non-depressive disorders and depressive disorders groups(χ2=0.34,P=0.56).V2/V1 of progressive subgroups was larger than that of stable subgroups,and V2/V1 of depressive disorders groups was significantly different from that of non-depressive disorders in progressive subgroups(F=167.39,P=0.00).Systolic blood pressure and fasting blood glucose were significantly higher in the progression of the disease,and there was a significantly correlation between fasting blood glucose and depressive disorders(r=0.425,P=0.000).Conclusions Depressive disorders can promote the progression of early motor deficits in cerebral infarcts of basal ganglia region.

Objective To explore the significance of LDL-C/HDL-C ratio in the pathogenesis of symptomatic intracranial atherosclerotic stenosis(sICAS) among young and middle-aged patients.Methods According to the NIHSS scores,37 young and middle-aged patients with newly-diagnosed sICAS were divided into two case-groups.Meanwhile,40 young and middle-aged patients with dizziness were selected as control group.The differences of LDL-C/HDL-C ratio between case-groups and control group were analyzed.After 6-month treatment,vascular lesions and LDL-C/HDL-C ratio were analyzed again,and then compared with the data collected prior to the treatment.Results As compared with normal controls,lower HDL-C value and increased LDL-C/HDL-C ratio were observed in young and middle-aged patients with sICAS.The differences between case-groups and control group were statistically significant.As compared with the condition before the treatment,64.71% of case-groups showed improved intracranial vascular stenosis and decreased LDL-C/HDL-c ratio upon treatment.The difference between before and after the treatment was also statistically significant.Conclusions Increased LDL-C/HDL-c ratio is an important risk factor for young and middle-aged patients with sICAS.Aspirin plus atorvastatin combined therapy can decrease LDL-C/HDL-c ratio and improve sICAS in young and middle-aged patients.