脑卒中后认知障碍与抑郁的相关因素分析

Analysis of related factors on depression for stroke patients with cognitive impairment

目的探讨脑卒中后认知功能障碍患者的抑郁情绪与各种因素之间的关系.方法对1997～2004年间住院脑卒中患者入院时进行老年认知功能量表(SECF)、自评抑郁量表(SDS)、自评焦虑量表(SAS)和日常生活能力量表(ADL)检测.SECF≤90分236例中SDS≥50分为抑郁组(72例);SDS<50分为非抑郁组(164例).2个月后复查4种量表.记录患者入院时SECF、ADL、SAS,以及SECF、ADL、SAS和SDS前后差值共7个变量,分别以其中1个变量为因变量,其他6个变量为自变量进行多元逐步回归.结果抑郁组患者抑郁情绪的改善及ADL能力的提高有助于降低焦虑、提高认知功能(P<0.05).改善焦虑情绪、提高认知功能有助于减轻抑郁、提高ADL(P<0.05).SDS与ADL差值、SAS与SECF差值呈负相关(P<0.05).结论住院康复治疗中减轻抑郁、焦虑情绪,提高日常生活能力和认知功能应同时进行,能起到互相促进作用,更好地治疗脑卒中后认知功能障碍.

Objective To explore the relationship between depression in stroke patients with cognitive impairment and possible factors. Methods 236 cognitive impaired patients whose score of Scale of Elderly Cognitive Function （SECF） ≤90 were selected in this study from inpatients with stroke from 1997 to 2004. They were evaluated with SECF, the Self-rating Depression Scale （SDS）, the Self-rating Anxiety Scale （SAS） and the Ability of Daily Living （ADL） immediately and 2 months after hospitaliza：don. 72 patients were in the depression group（SDS≥50） ,and 164 patients were in the no-depression group（SDS〈50）. Gradual regression analysis was applied. One factor was taken as dependent variable selected from immediate scores of SECF, ADL, SAS, and the change of scores of SECF, ADL, SAS, SDS, respectively, while others were taken as independent variables. Results The improvement of depression and ADL were helpful to reduce the anxiety and improve cognitive function in depression group （P〈0.05）, as well as the improvement of anxiety and cognitive function were helpful to improve the depression and ADL （P〈0.05）. The negative correlation were found between the difference former and latter score of SDS and ADL, as well as between those of SAS and SECF （P〈0.05）. Conclusion Patients with cognitive impairment can be beneficial from reducing depression and anxiety companied with improving the ADL and cognitive function, which is also mutually beneficial.