脑卒中后抑郁障碍的患病率及相关危险因素分析

Analysis of prevalence and risk factors for post-stroke depressive disorder

目的探讨在门诊就诊的脑卒中后患者抑郁障碍的患病率及其危险因素。方法选择在脑卒中专病门诊连续就诊的资料完整的脑卒中后初次就诊的患者1055例,按有无抑郁障碍分为两组。统计抑郁障碍的患病率,分析影响抑郁障碍发生的因素,单因素分析有意义的因素再进行多因素Logistic回归分析。结果 1055例患者中291例（27.6%）有抑郁障碍。单因素分析显示,抑郁障碍患者中女性、教育程度低、经济条件差、高血压、心脏疾病史、高脂血症、脑卒中史以及有高血压和心脏疾病家族史的构成比显著高于无抑郁障碍者（P值均〈0.05）。多因素Logistic回归分析显示,女性（RR=1.450,95%CI为1.087~1.936,P=0.012）、经济条件差（RR=6.451,95%CI为1.093~1.938,P=0.010）、高血压（RR=1.615,95%CI为1.135~2.298,P=0.008）、高脂血症（RR=2.085,95%CI为1.490~2.918,P〈0.001）、脑卒中史（RR=1.443,95%CI为1.034~2.014,P=0.031）及有心脏疾病家族史（RR=1.844,95%CI为1.228~2.769,P=0.003）是独立相关因素。结论在门诊就诊的脑卒中后患者中抑郁障碍的患病率为27.6%。女性、经济条件差、多种血管性危险因素是脑卒中后抑郁障碍的独立相关因素。

Objective To investigate the prevalence and risk factors of depressive disorder in post-stroke patients. Methods A total of 1 055 consecutive patients were enrolled in the present study at their first visits after stroke. The patients were divided into depressive disorder group and non-depressive group. The prevalence of depressive disorder was assessed and the risk factors of depressive disorder were analyzed by multivariable Logistic regression. Results Two hundreds and ninety-one patients （27.6%, 291/1 055）were diagnosed as post-stroke depression. Compared with non-depressive patients, female gender, low education （9 years）, low economic status, presence of hypertension, heart disease, hyperlipidemia, history of stroke, family history of hypertension and heart disease were all significantly higher in the depressive patients （P0.05） .Multivariable Logistic regression analysis showed that female gender（RR=1.450, 95%CI： 1.087-1.936, P=0.012）, low economic status （RR=1.456, 95%CI： 1.093-1.938, P=0.010）, hypertension（RR=1.615, 95%CI： 1.135-2.298, P=0.008）, hyperlipidemia（RR=2.085, 95%CI： 1.490-2.918, P0.001）, history of stroke （RR=1.443, 95%CI： 1.034-2.014, P=0.031）, and family history of heart disease（RR=1.844, 95%CI： 1.228-2.769, P=0.003）were the independent risk factors for depressive disorder in post-stroke patients. Conclusion The post stroke depression rate is 27.6% in our group. Female gender, low economic status, hypertension, hyperlipidemia, history of stroke and family history of heart disease are independent risk factors for post stroke depression.