老年脑梗死患者恢复期抑郁与认知和神经功能障碍的关系

Relation of depression with cognitive impairment and neurological deficits in el derly people at the recovery phase after cerebral infarction

目的:探讨首次发作的老年脑梗死患者恢复期抑郁与认知和神经功能障碍的关系,为恢复期脑梗死患者的康复干预提供理论依据。方法:对出院3个月的老年脑梗死患者87例行汉密顿抑郁量表(HAMD、简易智力状况检查MMSE和改良爱丁堡-斯堪的那维亚量)()表SSS)评定,以HAMD总分20分为界限分为抑郁组(n=36)和非抑郁(组(n=51),评估两组患者的抑郁程度,认知和神经功能缺损程度。结果:抑郁组HAMD总分(26.97±5.94)高于非抑郁组(11.96±3.03),各因子分也高于非抑郁组,差异均有显著性意义(P=0.000)。两组脑梗死灶数量、两组左侧、右侧及双侧梗死比较,差异无显著性意义(P>0.05)。抑郁组MMSE总分(19.64±5.22)低于非抑郁组(25.84±4.77);抑郁组SSS总分18.58±8.00)高于非抑郁组7.57±5.26),差异均有显著((性意义(P=0.000)。HAMD总分、因子分与MMSE总分呈负相关(r=-0.658～-0.248),与SSS总分呈正相关(r=0.275～0.728)。结论:恢复期老年脑梗死患者抑郁与认知障碍和神经功能障碍有关。

AIM:To study relation of depression after cerebral infarction in elderly peopl e at the recovery phase with cognitive impairment and neurological deficits in o rder to provide theoretical evidence for rehabilitation interventional of patien ts with cerebral infarction at the recovery phase. METHODS:Eighty seven elderly patients with the first episode of cerebral inf arction were enrolled and investigated with Hamilton rating scale for depression (HAMD),mini mental state examination(MMSE) and Scandinavian stroke scale(SSS).A ccording to the total score of HAMD(20 points),they were divided into depressive group(n=36)and non depressive group(n=51). The degree of depression,cognit ive impairment and neurological deficits was evaluated in the two groups. RESULTS:The total score of HAMD was significantly higher in the depressive gr oup(26.97±5.94) than the non depressive group(11.96 ±3.03) as well as the fac tor scores of HAMD(P=0.000).The location of left,right and bilateral infarction and number of infarct lesions were not significantly different between the depre ssive group and non depressive group(P >0.05).The total score of MMSE in the de pressive group was 19.64±5.22,significantly lower than that in the non depress ive group(25.84±4.77),and the total score of SSS in the former group was 18.5 8±8.00,significantly higher than that in the latter one(7.57±5.26)(P=0.000). The total score and factor score of HAMD were negatively related to the total sc ore of MMSE and positively related to the total scores of SSS in all patients(r= 0.275-0.728). CONCLUSION:Depression in elderly patient with cerebral infarction at the reco very phase is correlated with cognitive impairment and neurological deficits.