脑卒中患者抑郁障碍的临床研究

Study of Depression Status in Patients of Post-stroke

目的观察脑卒中住院患者抗抑郁治疗的有效性及探讨与脑卒中后情绪抑郁障碍相关的因素。方法①确诊抑郁症的脑卒中患者随机分为治疗组和对照组,治疗组再随机分为药物治疗组和心理干预治疗组,12周后分别测量三组患者神经功能缺失评分、日常活动能力评分、生活质量指数评分、汉密尔顿抑郁量表(HAMD)-17项评分、欧洲卒中量表(ESS)评分。②以神经功能缺失评分、ESS评分、日常活动能力评分、生活质量指数评分为变量分析脑卒中患者抑郁的主要相关因素。结果脑卒中患者发生率67.39%,其中轻度抑郁19.57%,中度抑郁29.35%,重度抑郁18.4%。三组患者的神经功能缺失评分、ESS差异无统计学意义(P>0.05)。生活质量指数评分、日常活动能力评分、HAMD-17项有统计学差异(P<0.05)。其中日常活动能力评分的贡献率最大达26.23%。结论①脑卒中后患者的HAMD-17与生活质量指数评分、日常活动能力评分、ESS评分、神经功能缺失评分相关。②合理的抗抑郁治疗(药物和心理治疗)利于改善患者的抑郁情绪。

Objective To study the affection of the treatment in the patients of the past - stroke with the depression status and the relationship among some facts. Methods ① To evaluate the prevalence of depression status in the patients of post - stroke. ② To observe the affection of the treatment in drug group, mental treatment group, control group. To analyzeis the related factors of the post -stroke patients with the depression status. Results The rate of depression in the patients of the chronic obstructive pulmonary disease is 67.39%. There are statistical difference among drug treatment group, mental treatment group, control group. The scores of QOL ADL ESS are related with the HAMD＇s （ P 〈 0. 05 ）. Conclusion ①The prevalence of depression in the chronic obstructive pulmonary disease is height.②Treatment of depression is benifited with patients of post - stroke.