| Post-stroke depression, which is characterized by bad mood, sleeping and the decline of interests et al, is one of complications of stroke. PSD is one of the independend factors on relapsed stroke and rehibilitation. The incidence is as high as 30-44%. Recently, lots of studies were carried on the diagnoses or therepy of PSD. Changes of monoamine neurotrans mitters play an important role on the genenation and development of PSD. Many factors affect to PSD, including neurobiological factors(neuological function deficits and ability of daily living) and scocial psychological factors (social support and family relationship).There are some differences about the related factors of PSD between our country and outsides. Further more, PSD may influence the recovery of neurological function. How to treat and prevent PSD play an important role on the recovery of neurological function and improving of living quality after cerebral vascular diseases. The most important thing to decrease PSD is to strengthen therapy on acute stages of stroke and to try to decrease neuological function deficits, at the same time, to strenghten nursing during recovery stage and discover high dangous patients early. Medicines on PSD include selective serotomin reuptake inhibitors and other antidepressant medicines. All of those medicines are chemical synthetizes with obviously side effects, which are difficult for patients to endure. So medicines with little side effects and with good effeets on cerebral vascular diseases are demanded on clinical. The study is about clinical related factors of PSD and diffenences on antidepressant effects of neuostan and fluoxetine on the base of detecting monoamine neurotrans mitters of PSD patients, to observe the changes of monomine neurotrans mitters on PDS, to discuss the clinical related factors of PSD and clinical treatment of neurostan. According to the diagnose standard of CCMD-â…¡-R to make a study of stroke patients. Using HAMD evaluate the degree of depression, and fluorescence spectrum photometer detect the concentrations of monoamine neurotrans mitters (5-HT.NE), and the rating scale of NFD and ADL were adopted. Neurostan and fluoxetine were administrated to study clinically. Results appear that the incidence of PSD is 43.3%. The decline of monoamine neurotrans mitters was related to the location of stroke, degree of neurological function deficits and ability of daily living. The scales of depression was positive relationship with the degree of neurological dysfunction and obviously negative relationship with ability of daily living. The effective rate of neurostan and fluoxetine is 83.8% and 85.0% respectively. Both of them could decrease the HAMD reduced rate and improve the recovery of neurological function deficits. The time of neurostan's effective treatment is earlier than that of fluoxetine's, and neurostan's bad effects are low. The study evaluated the concentrations of monoamine neurotrans mitters(5-HT,NE) in serum of PSD patients with methods of fluorescence spectrum. The result appears that the occurrence of PSD was related to the decline of monoamine neurotrans mitters'concentrations. Documents report that PSD was related to left, right and anterior, posterior locations of lesion. The scales of HAMD in left, anterior and cortical is higher than those in other sites, because the mood fibers of those sites were destroyed greatly. After stroke, NE nervous, 5-HT nervous and their passageway are destroyed. It make the compound of the two mitters decline to cause depression. The occurrence of PSD not also cause physical symptom worsen, but also cause psychological pain. Physical symptom and depression influenced each other, and both of them make a vious circle, which greatly affect the recovery of neurological functional deficits. A lot of researchers believe that PSD is related to the degree of NFD. Our study find out that the scales of HAMD is positive relationship with the degree... |
