脑梗死后抑郁症状与脑血流量的关系

Relationship between depressive symptoms following cerebral infarction and cerebral blood flow

目的探讨脑梗死后抑郁症状的发生与脑血流量的相关性。方法根据汉密顿抑郁量表评分判定标准,将首次发病的480例急性脑梗死患者分为两组,汉密顿抑郁量表总分≥8分者为研究组(脑梗死后抑郁组)224例,<8分者对照组(无抑郁症状组)256例,采用美国国立卫生研究院卒中量表评定两组神经功能缺损状况;检测两组患者脑血流量情况并进行对比分析。结果研究组左侧半球除中央区外,其他各部位脑血流量显著低于右侧对应部位;双侧半球平均脑血流量,额叶、颞叶、顶叶局部脑血流量显著低于对照组(P<0.05或0.01)。研究组脑血流量异常发生率显著高于对照组(χ2=29.02,P<0.01);抑郁程度越严重,大脑各部位脑血流量越低。研究组卒中量表评分显著高于对照组(P<0.01),抑郁程度与患者肢体运动功能、病残程度重和日常生活能力等因素密切相关。结论性脑梗死患者抑郁症状与脑血流量下降有关,脑血流量可作为评价急性脑梗死患者抑郁症状的一项客观指标。

Objective To explore the correlation between depressive symptoms following cerebral infarction and cerebral blood flow（CBF）. Methods According to the scores of the Hamilton Depression Scale （HAMD） 480 patients with first-episode acute cerebral infarction were dicided into research group（n= 224,the HAMD total score ≥ 8,depression group）and control group（n=256,〈8,non-depression group）, neurologic impairment assessed with the NIH Stroke Scale（NIHSS） and CBFs detected and contrasted of both 2 groups. Results In the research group,the CBF of each region of left hemisphere was significantly lower then that of corresponding region of right hemisphere,except cebtral region;bilateral-hemisphere average CBF and regional CBF of frontal, temporal and apical lobe were significantly lower in the research than in the control group（P〈0.05 or 0. 01）, incidence of CBF abnormality significantly higher（P〈0.01） in the research than in the control group;the more severe was depression,the lower was the regional CBF. The NIHSS score was significantly higher in the research than in the control group（P〈0.01） and depression degrees were closely related to mem motor function,disability degrees and activity of daily living. Conclusion Depressive symptoms of patients with acute cerebral infarction are related to the CBF descent. CBF may be regarded as an objective index assessing depressive symptoms of patients with acute cerebral infarction.