抑郁对卒中急性期患者早期康复的影响

Effects of depression on early restore of patients with stroke in acute stage

目的探讨抑郁与卒中急性期患者早期康复的关系。方法选择卒中急性期并发抑郁（PSD）患者144例，随机分为抑郁干预组及抑郁未干预组，并与同期卒中急性期不伴有抑郁患者72例（单纯卒中组）作对照。全部患者均按卒中常规治疗，抑郁干预组在此基础上给予心理治疗或抗抑郁剂合并心理治疗；各组分别在治疗前、治疗后1、2．4周进行汉密尔顿抑郁量表（HAMD）、中国卒中量表（CSS）、改良Barthel指数记分法（MBI）评分。结果卒中急性期PSD患者（抑郁干预组及抑郁未干预组）与单纯卒中组相比，神经功能恢复较差（P〈0．05，P〈0．01）；抑郁未干预组CSS及MBI的改善明显低于抑郁干预组（P〈0．01）。结论卒中急性期PSD能严重影响患者的早期康复，可作为卒中预后的评估方法之一。早期抑郁干预可明显改善患者的神经功能和生活能力。

Objective To explore the relationship between depression and early restore of patients with stroke in acute stage. Methods One hundred and forty - four patients with post - stroke depression in acute stage were divided into depressive intervention group and depressive nonintervention group. Seventy - two patients with pure stroke were used as control. All patients were treated with medicines at the same time. The depressive intervention group received psychological intervention or antidepressant medicine and psychological intervention simultaneously. HAMD,CSS and MBI were determined before and after 1,2 and 4 weeks treatment. Results The poor outcome was founded in patients with post - stroke depression in acute stage （ P 〈 0.05, P 〈 0.01 ）. CSS and MBI of the depressive nonintervention group were significantly lower as compared with the depressive intervention group （ P 〈 0.01 ）. Conclusion Post -stroke depression in acute stage has negative in- fluence on early restore of stroke and may be helpful for evaluating the prognosis. Antidepressant treatment early may be promising to improve CSS and MBI.