帕金森病伴抑郁患者DBS 术后帕罗西汀治疗疗效观察

目的:研究丘脑底核(STN)脑深部电刺激(DBS)治疗帕金森病(PD)合并抑郁障碍术后服用帕罗西汀治疗的疗效。方法:将38例合并抑郁障碍的PD患者随机分为三组,行丘脑底核脑深部电极植入术,术后空白对照组不服用任何抗抑郁药物,药物治疗组服用帕罗西汀每日一次,每次20mg,安慰剂组服用安慰剂。术前一周,术后1个月、2个月和3个月进行随访和临床评价。结果:抑郁患者术后抑郁障碍症状如焦虑、绝望和激越症状也有不同程度好转,应用安慰剂后,患者术后抑郁障碍程度好转程度大于空白对照组(P<0.05),而应用帕罗西汀后术后3个月汉密尔顿抑郁量表评分(HAMD)下降程度显著低于空白对照组及安慰剂组(P<0.05)。结论:表明STN-DBS术后PD患者的抑郁症状有所改善,辅助抗抑郁药物治疗效果更佳。

Effects of Paroxetine in Treatment of Parkinson's Disease withDepression after Deep Brain Stimulation

Objective: To study the effects of paroxetine in treatment of Parkinson''s disease with depression (PDD) after deepbrain stimulation (DBS) of the bilateral subthalamic nucleus ( STN). Methods: A total of 38 PDD patients were randomly divided intothree groups, All patients were selected for STN-DBS, after surgery, control group with nothing antidepressant, themedication group withtherapied by Paroxetine,another group with placebo. Assessment was performed before and 1, 2, 3 months after surgery. Depression wasevaluated using the Hamilton Rating Scale for Depression (HAMD). Results: After surgery, The depressive disorders such as anxiety,despair and agitate were alleviated , the placebo group''s effect outgo the control group (P<0.05), the themedication group''s scores ofHAMD decreased significantly than control group and placebo group (P<0.05). Conclusion: Bilateral STN-DBS improves the depressivesymptoms in Parkinson''s disease patients,and auxiliary antidepressants have better effects in treating PDD patients.