卒中后老年患者抑郁症的临床研究

Clinical study of old patients with post-stroke depression

目的 探讨老年患者卒中后抑郁症的临床特点及治疗。 方法 对124例卒中后老 年患者采用抑郁症量表(HAMD)评定,≥17分者确定为抑郁症。观察抑郁症的临床表现和服用 氟西汀(Fluoxitine)的治疗效果;分析抑郁症的产生与卒中后脑血管损害部位、神经功能缺失程 度、文化程度等之间的关系。 结果 124例老年卒中患者中有61例HAMD≥17,卒中后老年患 者抑郁症的发生率为49.2%,大脑皮质下脑血管病患者抑郁症发生率更高;神经功能缺失程度、 文化程度与抑郁症有显著相关性(r=0.853,P<0.01);日常生活依赖程度评分与HAMD呈显著 负相关(r=-0.757,P<0.01)。氟西汀治疗抑郁症有效。 结论 对卒中后并发抑郁症的老年 患者,在积极治疗原发病的同时,进行抗抑郁治疗临床效果更好。

Objective To explore the clinical features and the therapy of old patients with post-stroke depression. Methods 61 old patients with post-stroke depression were studied prospectively. The clinical manifestation of these patients and the treatment result of fluoxitine were observed. The relation between the occurrence of disease and the location of brain damage, the neurological dysfunction and the education of the patients were analyzed. Results The incidence of the depression was relatively high, especially in the old patients with subcortical cerebrovascular disease. The degree of neurological dysfunction,and the educated condition of the patients were remarkably related to depression . fluoxitine was effective for the treatment of depression. Conclusion While the primary disease is treated positively,it is better to start the anti-depression treatment simultaneously for old patients with post-stroke depression.