目的 探討帕羅西汀治療卒中后抑郁/焦慮的療效及安全性。方法 選取西安市第一醫(yī)院收治的312例腦卒中后抑郁/焦慮患者，隨機均分為觀察組和對照組。對照組患者予以常規(guī)、對癥、支持治療及康復(fù)訓練、心理干預(yù)，觀察組在此基礎(chǔ)上予以鹽酸帕羅西汀治療，每次1片，每日清晨服1次。所有患者治療2個月。比較分析兩組的臨床療效，患者治療前后的Hamilton抑郁量表（HAMD）評分、焦慮量表（HAMA）評分，血漿P物質(zhì)（SP）、神經(jīng)肽Y（NPY）、皮質(zhì)醇（Cor）含量及副作用量表（TESS）評分。結(jié)果 治療后，兩組患者的HAMD、HAMA評分均明顯下降（P<0.05），且觀察組顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。對照組和研究組的臨床總有效率分別為60.26%和87.82%，研究組明顯優(yōu)于對照組，差異有統(tǒng)計學意義（P<0.05）。兩組患者的SP、Cor均明顯下降，NPY明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；并且觀察組的改善程度高于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組有部分患者出現(xiàn)了厭食、惡心、頭暈、失眠等反應(yīng)，但均可耐受，觀察組的TESS評分與對照組相比差異無統(tǒng)計學意義。結(jié)論 帕羅西汀治療卒中后抑郁/焦慮能夠有效降低抑郁、焦慮癥狀，改善神經(jīng)肽和皮質(zhì)醇水平，療效顯著，安全性較好，值得臨床應(yīng)用和進一步研究。

Objective To investigate the efficacy and safety of paroxetine in the treatment of post-stroke depression and anxiety. Methods Patients with post-stroke depression and anxiety (312 cases) were randomly divided into observation and control groups. All patients were given routine, symptomatic, supportive treatment and rehabilitation training, psychological intervention, in addition, the observation group was treated with paroxetine hydrochloride. The Hamilton Depression Scale (HAMD) score, anxiety scale (HAMA) score, plasma substance P (SP), neuropeptide Y (NPY), cortisol (Cor) content and side effects scale (TESS) score of both groups before and after treatment were analyzed and compared. Results After treatment, the HAMD and HAMA scores of two groups were significantly decreased, and those of the observation group was significantly lower than the control group (P<0.05). The clinical curative effect of the observation group was better than that of the control group (P<0.05). In both groups, the levels of SP and Cor were significantly decreased, NPY was significantly increased, and the improvement of the observation group was higher than that of the control group (P<0.05). In the observation group, some patients had anorexia, nausea, dizziness, insomnia and other reactions, but they were tolerant, and there was no significant difference in the TESS score between the observation group and control group. Conclusion Paroxetine treatment of post-stroke depression/anxiety can reduce depression and anxiety symptoms, improve neuropeptide and cortisol levels, and have good curative effect and good safety. It is worthy of clinical application and further study.