413例脑梗死患者抑郁危险因素的前瞻性研究

Prospective Study of Depressed Risk Factors for 413 Cases of Cerebral Infarction

目的:观察和研究抑郁状态(PSD)的发生率及相关的危险因素。方法:采用前瞻性研究的方法,对413例脑梗死患者应用抑郁量表(CES-D)、汉密尔顿抑郁量表(HHAMD)、简易智力状态量表(MMSE)及Hachinski缺血指数量表(HIS)进行分析,统计PSD发生率及PSD的发生与年龄、性别、病程、神经功能缺损(SSS)、影像学诊断、脑梗死灶部位及其他因素的相关性。结果:413例脑梗死患者中符合PSD诊断的136例(32.9%)设为抑郁组,另277例设为对照组。抑郁组与对照组在A型行为、负性事件、并发症、SSS、影像学诊断、血管性痴呆(VD)和A性行为问卷(TABQ)评分等比较差异有显著性意义(P<0.05或0.01),非条件逐步logistic回归分析显示年龄、病程、SSS和影像学诊断为PSD的危险因素。结论:对于高龄、A型行为脑梗死患者,尤其是在恢复期,努力减少负性事件,积极治疗或防治并发症和VD,减少神经功能缺损程度是防治PSD的关键。

Objective： To observe and study the incidence and related risk factor for post-stroke depression （PSD）. Methods： By using the method of prospective study, the cases were selected and divided into depressed group and control group with CES-D, HHAMD, MMSE and HIS. The relationship between PSD occurrence and the factors of age, sex, courses of disease, SSS, photographic diagnosis, infarctional focal place and others was analyzed. Results： The incidence of depression in 413 cases of cerebral infarctiori was 33 %. There was significant difference between depressed group and control group in A-type behavior, negative events, SSS, photographic diagnosis, VD and TABQ marks （P〈0. 05 or P〈 0.01）. Non-conditional progressive logistic regressive analysis indicated that age, courses of disease, SSS and photographic diagnosis were risk factors for PSD. Conclusion： For patients with cerebral infarction at advanced ages and with A-type behavior, especially at convalescence, it is a key to decrease the negative event hard, to prevent and treat complications and VD actively, to treat cerebral infarction and decrease the condition of nervous function shortcoming actively for prevention and treatment of PSD.