脑卒中后抑郁状态对预后的影响:7年随访

The impact of post-stroke depression on prognosis of stroke patients:a 7-year follow-up study

目的研究脑卒中后抑郁状态(post-stroke depression,PSD)对脑卒中患者7年生存率、卒中复发率、病残程度分级、日常生活能力指数(Barthel Index,BI)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分等预后指标的远期影响。方法研究对象来源于2000年前期研究中北京市7个区12家医院的616例脑卒中患者,根据基线时HAMD评分分为PSD组和非PSD组,7年后应用自制一般情况调查表、病残程度分级表、BI、HAMD进行随访。结果 7年生存率为76.0%。101例女性PSD组患者7年生存率为75.25%,显著低于126例女性非PSD患者的86.56%(P=0.01);与410例非PSD组患者相比,206例PSD组患者BI较低(P=0.04)和HAMD评分较高(P=0.00),而卒中复发率、病残程度分级两组间无明显统计学差异(P>0.05)。结论 PSD可能会降低女性脑卒中患者的7年生存率,对日常生活能力和抑郁情绪有长期负面影响。

Objective To study the impact of post-stroke depression （PSD） on prognosis of stroke patients during seven years of follow-up. Methods The study subjects are 616 stroke patients derived from a prevalence investigation of 12 hospitals in 7 districts of Beijing, China, 2000. The patients were divided into two groups, PSD and non-PSD group, based on Hamilton Depression Rating Scale （ HAMD ） score. Patients were followed up by evaluating HAMD, Barthel Index （BI） , physical disability grades and a self-designed register form. Results The seven year survival rate was 76.0%. The survival rate of 101 PSD female patients was 75.25%, which was lower than that of 126 non-PSD female patients （86. 56% ） （P = 0. O1 ）. Compared with non-PSD patients, PSD patients had lower score of BI （ P = 0. 04） and higher score of HAMD （P = 0. 00）. There was no significant difference in recurrent rate of stroke and physical disability grades be- tween PSD group and non-PSD group （ P 〉 O. 05 ）. Conclusions PSD may reduce the 7-year survival rate of female stroke patients and has long-term negative impact on living ability and depression.