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中风后抑郁:一个被低估的临床难题(2022年)

Poststroke Depression, An Underrated Clinical Dilemma: 2022.

作者信息

Jamil Aneeque, Csendes Denise, Gutlapalli Sai Dheeraj, Prakash Keerthana, Swarnakari Kiran Maee, Bai Meena, Manoharan Mohana Priya, Raja Rabab, Desai Aditya, Desai Darshi M, Arcia Franchini Ana P

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2022 Dec 26;14(12):e32948. doi: 10.7759/cureus.32948. eCollection 2022 Dec.

Abstract

It is known that the majority of patients are prone to develop depression following a stroke. Several biological factors, including the disruption of the hypothalamic and adrenal axis and changes in cortisol and interleukin 6 (IL6), are said to have an essential role in its development. Magnetic resonance imaging (MRI) scans point toward white matter lesions and lacunar infarcts as the primary pathological culprit. People affected by poststroke depression (PSD) are more likely to commit suicide or develop another ischemic event after the initial episode, which can likely increase the mortality related to PSD and stroke. Selective serotonin reuptake inhibitors (SSRIs) are the mainstay of treatment for PSD. However, it has a poor safety profile and is not very productive, making the use of SSRIs controversial, and further studies are required to prove its benefits concerning PSD. This literature review discusses the importance of PSD, how it impacts the quality of life of people affected by stroke, and its treatment.

摘要

众所周知,大多数中风患者容易在中风后患上抑郁症。包括下丘脑和肾上腺轴的紊乱以及皮质醇和白细胞介素6(IL6)的变化在内的几种生物学因素,据说在其发病过程中起着至关重要的作用。磁共振成像(MRI)扫描表明,白质病变和腔隙性梗死是主要的病理元凶。中风后抑郁症(PSD)患者在首次发病后更有可能自杀或发生另一次缺血性事件,这可能会增加与PSD和中风相关的死亡率。选择性5-羟色胺再摄取抑制剂(SSRI)是PSD治疗的主要药物。然而,其安全性不佳且效果不太显著,这使得SSRI的使用存在争议,需要进一步研究来证明其对PSD的益处。这篇文献综述讨论了PSD的重要性、它如何影响中风患者的生活质量以及其治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec66/9879592/65aabb9ad56f/cureus-0014-00000032948-i01.jpg

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