脑卒中患者抑郁状态对生活质量和神经功能恢复的影响(英文)

Effects of post-stroke depression on the quality of life and the recovery of neurological function

背景:脑卒中后抑郁状态(post-stroke depression,PSD)及其抗抑郁治疗对脑卒中患者神经功能恢复和生活质量的影响尚无肯定的结论。PSD的发生率较高,因此,此项研究应向定量化深入。目的:通过对PSD和抗抑郁干预,探讨PSD对脑卒中患者生活质量和神经功能恢复的影响。设计:以诊断为依据,随机对照研究。单位:河南安阳钢铁集团公司职工总医院神经内科,湖北中医学院神经科,湖北省红安县人民医院内科。对象:2001-08/2002-03河南安阳钢铁集团公司职工总医院神经科门诊和住院的PSD患者41例,男25例,女16例;年龄61.7±12.1)(岁,随机分为抑郁组20例和非抑郁组21例。干预:抗抑郁组在第1个月汉密顿抑郁量表(HAMD评定后开始服用阿)米替林和心理辅导。在发病1个月和3个月时采用卒中生活质量量表(SS-QOL)和欧洲临床神经功能缺失评分标准ESS)进行评定,观察神经(功能缺失、生活质量和抑郁症状的改善。主要观察指标:①两组患者在第1,3个月时HAMD,ESS和SS-QOL评分。②SS-QOL各项指标评分结果。③抗抑郁组治疗效果。结果:抗抑郁组治愈者16例,治愈率76%(16/21),4例比治疗 前减少5分以上,总有效率为95%(20/21)。抗抑郁组SS-QOL评分显示在情绪、体能、家庭活动、社会活动、思维能力和工作能力等方面均有不同程度的改善。

BACKGROUND:There was no positive conclusion on the effects of the post stroke depression(PSD) and its treatment of anti depression on the recovery of neurol ogical function and the quality of life (QOL) of the stroke patients.The inciden ce of PSD was high, so the research on the effects should be deepened quantitive ly. OBJECTIVE:To investigate the effects of PSD on QOL and the recovery of neurolo gical function of stroke patients via the interventions of PSD and anti depress ion. DESIGN:A randomized and controlled study based on the diagnosis. SETTING:Department of Neurology,General Staff Hospital of Anyang Steel and Iro n Group Co.of Henan Province;Department of Neurology,Hubei College of Traditiona l Chinese Medicine;Department of Internal Medicine,Hongan County People's Hospit al of Hubei Province. PARTICIPANTS:A total of 41 PSD outpatients and inpatients, 25 male and 16 fema le with the age of(61.7±12.1) years old,were selected from the Department of Ne urology,General Staff Hospital of Anyang Steel and Iron Group Company of Henan P rovince from August 2001 to March 2002.All the patients were randomly divided in to depression group with 20 patients and non depression group with 21 patients. INTERVENTION:Before receiving amitriptyline and the mental guidance, the patie nts in anti depression group were assessed with Hamilton depression rating scal e(HAMD) during the first month. Stroke scale quality of life(SS QOL) and Europe an clinical neurologic impairment scale(ESS) were adopted to assess and observe the improvement of neurologic impairment,QOL and depression symptom during the f irst and the third month episode. MAIN OUTCOME MEASURES:①Scores of HAMD,ESS and SS QOL of patients in those tw o groups during the first and the third month;②The results of each SS QOL;③Th e therapeutic efficacy of anti depression group. RESULTS:Among the patients in anti depression group,16 patients were cured wi th the cure rate of 76%(16/21).Four patients had at least five score decreased after treatment,and the total effective rate was 95%(20/21).The scores of SS Q OL in anti depression group showed that there were some improvements on many as pects,such as mood,physical ability, family activities, social activities,thinki ng ability,work ability and so on. CONCLUSION:PSD can affect the recovery of neurological function and QOL of str oke patients.And the treatment in anti depression group is significant to the i mprovement of the prognosis of patients.