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是否有必要?卒中后抑郁的预防治疗:RCT 的荟萃分析。

Are they necessary? Preventive therapies for post-stroke depression: A meta-analysis of RCTs.

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Changping Rd, Shantou 515041, Guangdong, China; College of Medicine, Shantou University, Shantou, Guangdong, China.

College of Medicine, Shantou University, Shantou, Guangdong, China.

出版信息

Psychiatry Res. 2020 Feb;284:112670. doi: 10.1016/j.psychres.2019.112670. Epub 2019 Oct 31.

Abstract

To explore the necessity and feasibility of early anti-depressive therapies in acute stroke patients, we conducted a meta-analysis of currently available randomized control studies (RCTs). Literature search in six databases was done with keywords of cerebrovascular accident, depression and prevention. Only RCTs that met the inclusion criteria were enrolled for further analysis. Twelve eligible studies were included in this meta-analysis. Prophylactic anti-depressive therapies following acute stroke were shown to reduce the incidence of depression in the patients (RR = =0.33, 95% CI: 0.25 to 0.43, p < 0.001), improve symptoms of depression (WMD: 5.73, 95% CI: 4.18 to 7.29, p < 0.001), improve motor function (WMD: 12.56, 95%CI: 9.07 to 16.04, p < 0.001) and neurological function (WMD: 1.13, 95%CI: 0.57 to 1.69, p < 0.001). However, anti-depressive therapies showed no effects on mortality (RR = 1.63, 95%CI: 0.55 to 4.85, p = 0.377) and adverse events incidence (RR = 0.93, 95%CI: 0.53 to 1.64, p = 0.806). Anti-depressive therapies following acute stroke is effective thus deserves to be advocated.

摘要

为了探索急性脑卒中患者早期抗抑郁治疗的必要性和可行性,我们对现有的随机对照研究(RCT)进行了荟萃分析。使用脑血管意外、抑郁和预防三个关键词在六个数据库中进行文献检索。只有符合纳入标准的 RCT 才被纳入进一步分析。这项荟萃分析共纳入了 12 项符合条件的研究。结果显示,急性脑卒中后预防性抗抑郁治疗可降低患者抑郁发生率(RR=0.33,95%CI:0.25 至 0.43,p<0.001),改善抑郁症状(WMD:5.73,95%CI:4.18 至 7.29,p<0.001),改善运动功能(WMD:12.56,95%CI:9.07 至 16.04,p<0.001)和神经功能(WMD:1.13,95%CI:0.57 至 1.69,p<0.001)。然而,抗抑郁治疗对死亡率(RR=1.63,95%CI:0.55 至 4.85,p=0.377)和不良事件发生率(RR=0.93,95%CI:0.53 至 1.64,p=0.806)无影响。因此,急性脑卒中后进行抗抑郁治疗是有效的,值得提倡。

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