目的 探讨帕罗西汀治疗卒中后抑郁/焦虑的疗效及安全性。方法 选取西安市第一医院收治的312例脑卒中后抑郁/焦虑患者，随机均分为观察组和对照组。对照组患者予以常规、对症、支持治疗及康复训练、心理干预，观察组在此基础上予以盐酸帕罗西汀治疗，每次1片，每日清晨服1次。所有患者治疗2个月。比较分析两组的临床疗效，患者治疗前后的Hamilton抑郁量表（HAMD）评分、焦虑量表（HAMA）评分，血浆P物质（SP）、神经肽Y（NPY）、皮质醇（Cor）含量及副作用量表（TESS）评分。结果 治疗后，两组患者的HAMD、HAMA评分均明显下降（P<0.05），且观察组显著低于对照组，差异有统计学意义（P<0.05）。对照组和研究组的临床总有效率分别为60.26%和87.82%，研究组明显优于对照组，差异有统计学意义（P<0.05）。两组患者的SP、Cor均明显下降，NPY明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；并且观察组的改善程度高于对照组，差异有统计学意义（P<0.05）。观察组有部分患者出现了厌食、恶心、头晕、失眠等反应，但均可耐受，观察组的TESS评分与对照组相比差异无统计学意义。结论 帕罗西汀治疗卒中后抑郁/焦虑能够有效降低抑郁、焦虑症状，改善神经肽和皮质醇水平，疗效显著，安全性较好，值得临床应用和进一步研究。

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.