JAHA:SSRIs在改善脑卒中后恢复中的安全性和有效性

2022-06-25 MedSci原创 MedSci原创

该研究结果表明SSRIs在预防和治疗抑郁,改善焦虑,运动功能,认知功能和卒中患者的依赖方面是有效的。

一些研究调查了选择性5-羟色胺再摄取抑制剂(SSRIs)在改善卒中后恢复中的作用。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员进行了一项系统综述和荟萃分析,以探究SSRIs在卒中后恢复中的有效性和安全性。

在这项荟萃分析中,研究人员检索了以下数据库:PubMed、Cochrane、Scopus和谷歌学者。如果这些研究设计为安慰剂对照试验,并报道了SSRIs对卒中后抑郁、焦虑、残疾、依赖、运动能力和认知功能的影响,那么这些研究则被纳入在内。研究人员使用修订的随机试验Cochrane偏倚风险评估工具评估了纳入研究的质量。

研究人员共检索得到了包括16164名患者在内的44篇文献,大约一半的参与者接受了SSRIs治疗。研究结果显示,SSRIs对预防抑郁(加权平均差异[WMD]为−7.05[95%CI为−11.78至−2.31])、根据汉密尔顿抑郁量表评分(WMD为−1.45[95%CI为−2.77至−0.14])治疗抑郁、焦虑(相对风险为0.23[95%CI为0.09-0.61])、依赖(WMD为8.86[95%CI为1.23-16.48])、运动能力(美国国立卫生研究院卒中量表评分(WMD为−0.79[95%CI为−1.42至−0.15])、认知功能(WMD为1.00[95%CI为0.12-1.89])具有显著效应。

另一方面,研究人员没有观察到SSRIs对残疾的显著影响。此外,研究人员还发现使用SSRIs治疗会增加癫痫发作的风险(相对风险为1.44[95%CI为1.13-1.83]),而在胃肠道症状或出血的发生率上,SSRIs和安慰剂没有差异。

由此可见,该研究结果表明SSRIs在预防和治疗抑郁,改善焦虑,运动功能,认知功能和卒中患者的依赖方面是有效的。这些益处只在西酞普兰亚分析中重复出来,而氟西汀不能不能。还需要进行进一步的安慰剂对照试验,以调查西酞普兰在卒中患者中的安全性和有效性。

原始出处:

Heba M. Kalbouneh.et al.Safety and Efficacy of SSRIs in Improving Poststroke Recovery: A Systematic Review and Meta‐Analysis.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.122.025868

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    2022-06-26 zhaohui6731
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    2022-06-25 ms5000000518166734

    学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习

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