卒中后抑郁的特点及其相关因素的Logistic回归分析

Logistic Regression Analysis of the Features and Related Factors of Post-stroke Depression

目的研究卒中后抑郁(PSD)的特点和相关因素,为卒中后抑郁的干预提供依据。方法采用临床流行病学调查方法对门诊和住院的198例脑卒中患者进行卒中后抑郁及其相关因素的现状调查,运用抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)、简易智力状态检查(MMSE)、日常生活能力量表(ADL)、神经功能缺损量表(NFDS)和自制一般情况调查表对卒中患者进行评定,并用Logistic回归分析法对相关因素进行分析。结果卒中后抑郁的发生率为36.86%,其中轻度63.01%、中度26.03%、重度10.96%;卒中后抑郁的特点为睡眠障碍、绝望、运动阻滞和焦虑等为主要表现;经Logistic回归分析,卒中后抑郁发生的相关因素有负性生活事件、病灶数目、心血管病史、抑郁症史、病灶部位以及脑卒中史。结论卒中后抑郁发生率较高,以睡眠障碍、绝望、运动阻滞和焦虑等主要表现,其相关因素有负性生活事件、病灶数目、心血管病史、抑郁症史,它的发生可能是社会心理学因素和神经生物学因素共同作用的结果。

Objective To explore the features and related factors of post - stroke depression （ PSD） so as to provide a basis for PSD intervention. Methods A clinical epidemical investigation of PSD and related factors was made to 198 inpatients and outpatients ; Self - rating Depression Scale （ SDS ）. Hamilton Depression Rating Scale （ HAMD ） , Mini - mental State Examination （ MMSE ） , Activity of Daily Living Scale （ ADL ） , Neurological Function Deficit Scores （ NFDS ） and self - designed questionaire were used in the assessment while Logistic Regression Analysis was applied in analyzing related factors. Results The occurrence of PSD was 36. 86% with 63.01% of mild depression , 26.03% of moderate depression and 10. 96% of severe depression; the manifestation of PSD was of such features as sleeping disorder, despair, motor block and anxiety; Logistic Regression Analysis indicated the occurrence of PSD was related to the following factors： negative living accidents, the number of lesions, history of heart vascular diseases, history of depression, the lesion site and history of stroke. Conclusions The occurrence of PSD is high, with certain features and related factors, and social psychological and neurobiological factors coact in the occurrence.