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评估抗抑郁药使用对缺血性中风患者中风复发及相关结局的影响:一项倾向评分匹配分析。

Assessing the effects of antidepressant use on stroke recurrence and related outcomes in ischemic stroke patients: a propensity score matched analysis.

作者信息

Alamri Faisal F, Almarghalani Daniyah A, Alatawi Yasser, Alraddadi Eman A, Babateen Omar, Alayyafi Ahmed, Almalki Ziyad, Alsalhi Khaled, Alzahrani Khaled, Alghamdi Ahmed, Aldera Hussain, Karamyan Vardan T

机构信息

Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.

出版信息

Front Pharmacol. 2025 Mar 12;16:1558703. doi: 10.3389/fphar.2025.1558703. eCollection 2025.

Abstract

The effect of antidepressant use, particularly that of selective serotonin reuptake inhibitors, on stroke outcomes remains unclear. This hospital-based, retrospective, observational study utilized propensity score-matching (PSM) to assess the association between antidepressant use, stroke-related outcomes, and complications. The study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah and Riyadh and included 1,125 patients with acute-subacute ischemic stroke, of whom 1,025 were antidepressant non-users and 100 antidepressant users. After PSM, 200 patients (100 antidepressant users and 100 non-users) were included in the final analysis. This study aimed to assess the association between antidepressant use, stroke recurrence, and mortality. Additionally, the study examined the association between antidepressant use and stroke severity, functional independence, and incidence of post-stroke complications. The Kaplan-Meier analysis revealed no statistically significant differences in stroke recurrence ( = 0.5619) or mortality ( = 0.6433) between antidepressant users and non-users over the 1-year follow-up period. Additionally, no significant differences were observed in stroke severity at admission and discharge ( = 0.33210 and = 0.78410, respectively) or functional independence ( = 0.9176 and = 0.4383, respectively) between the two groups. These findings suggest that antidepressant use does not significantly affect stroke recurrence, mortality, stroke severity, or functional independence. However, further large-scale studies are warranted to validate these findings and investigate potential confounding factors, such as stroke subtypes, co-use of certain medications, and physical activity.

摘要

抗抑郁药的使用,尤其是选择性5-羟色胺再摄取抑制剂的使用,对中风预后的影响仍不明确。这项基于医院的回顾性观察研究采用倾向得分匹配法(PSM)来评估抗抑郁药使用、中风相关预后和并发症之间的关联。该研究在吉达和利雅得的阿卜杜勒阿齐兹国王医疗城(KAMC)进行,纳入了1125例急性-亚急性缺血性中风患者,其中1025例未使用抗抑郁药,100例使用抗抑郁药。经过PSM后,200例患者(100例抗抑郁药使用者和100例非使用者)纳入最终分析。本研究旨在评估抗抑郁药使用、中风复发和死亡率之间的关联。此外,该研究还考察了抗抑郁药使用与中风严重程度、功能独立性以及中风后并发症发生率之间的关联。Kaplan-Meier分析显示,在1年的随访期内,抗抑郁药使用者和非使用者在中风复发(P = 0.5619)或死亡率(P = 0.6433)方面没有统计学上的显著差异。此外,两组在入院时和出院时的中风严重程度(分别为P = 0.33210和P = 0.78410)或功能独立性(分别为P = 0.9176和P = 0.4383)方面也没有观察到显著差异。这些发现表明,使用抗抑郁药不会显著影响中风复发、死亡率、中风严重程度或功能独立性。然而,需要进一步的大规模研究来验证这些发现,并调查潜在的混杂因素,如中风亚型、某些药物的联合使用以及身体活动情况。

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