脑卒中后抑郁及认知功能的临床评价

Clinical Assessment of Depression and Cognitive Function in Post-stroke patients

采用ＭＭＳＥ评定认知功能、ＣＥＳ—Ｄ评定情感状况，对１２０例脑卒中住院治疗患者在发病后５～６周进行抑郁与认知功能的评定，以６０例高血压患者作为对照．结果表明，卒中患者ＭＭＳＥ积分明显低于对照（Ｐ＜０．００２），ＣＥＳ—Ｄ积分高于对照（Ｐ＜０．００１）；抑郁和认知障碍的发生率和严重程度均明显高于对照；多发性梗塞患者ＭＭＳＥ积分低于缺血性或出血性卒中患者（Ｐ＜０，０２，Ｐ＜０．０５），多发性梗塞和皮层病变容易发生抑郁；卒中的性质和部位与ＭＭＳＥ，ＣＥＳＤ积分无关，ＭＭＳＥ，ＣＥＳ－Ｄ积分与偏瘫无关．作者认为卒中后抑郁和认知障碍是生物、心理、社会多种因素共同作用的结果，但生物因素起重要作用．

We interviewed 120 stoke patients five to six weeks after thrir acute stroke to assess cognitive impairment using the Mini-Mental State Examination, mood disorders using Center of Epidenmiological Survey-Depression Scale.We also interviewed 60 hypertensive patients as control. As a result,Compared with age-and sex-matched control subjects both MMSE scores and CES-D Scores significant reduction were observed in post-stroke patients.The prevalence and the Severity depression. Cognitive impairment in post-stroke patients were greater than control subjects.MMSE scores of the patients with multiple cerebral infarcts was significantly lower than those with ischemic or hemorrhagic stroke. The patients with multiple cerebral infarcts and cortical lesion was prone to show depressive symptoms. Aralysis of variance failed to show significant correlations between MMSE and CES-D scores, qulity and locatiom of stroke,hemiplega. Fiaally,authors discussed the heterogenous causes of depression and cognitive impairment and think probably biological etiology involved in the formation of depression and cognitive impairment.