以抑郁首诊的脑梗死临床相关影响因素的研究

Study on Clinical Related Factors of Cerebral Infarction with Depression.

目的探讨以抑郁为首发症状的脑梗死患者的临床特点及其影响因素。方法对46例因抑郁障碍为首诊主诉,后经CT或M R I证实为脑梗死的患者,用抑郁自评量表(SDS)和汉密尔顿抑郁量表(HAM D)进行抑郁状态评定,对梗死部位、数量、合并症、生活方式、性别及受教育程度等相关因素统计分析。结果①46例被调查者中,轻度抑郁为58%,中度抑郁为34.3%,重度抑郁为6.5%;抑郁症状以焦虑/躯体化、迟缓和睡眠障碍为主;②比较左、右及双侧梗死组抑郁严重程度无显著差异(P>0.05),而皮质下及皮质合并皮质下梗死其抑郁有显著差异(P<0.05);多灶梗死组抑郁程度显著高于单灶梗死组(P<0.01);③抑郁与合并高血压、糖尿病及烟酒嗜好有关(P<0.05)。结论以抑郁障碍首次就诊的老年患者应警惕脑梗死的可能,其抑郁症状与梗死部位、合并疾病、生活行为方式等因素有关。

Objective To investigate clinical features and related factors of cerebral infarction patients with the depression as the first symptom. Methods There were 46 patients with primary diagnosis of depression due to chief complaints,and they were confirmed as cerebral infarction by CT or MRI. The Scale of SDS and HAMD were used to assess the level of depression. The statistical analysis was conducted, which including the number and place of infarction, complications, life style, gender, the level of education and other relevant factors. Results ①There were 46 people investigated, which mild depression was 58%, moderate depression was 34.3 % and severe depression was 6.5 % The chief symptoms of depression were anxiety,somatization,retardation and sleep disorders.②There was no significant difference among left,right and bilateral infarction groups in depression level （P〉0.05）. It was significantly different between subcortical infarcts and cortical combined subcortical infarcts groups in depression level （P〈0.05）. It was significantly different between multifocal infarction group and single lesions infarction group in depression level （P〈0.01 ）.③Depression was related to hypertension,diabetes and abused alcohol （P〈0. 05）. Conclusion The elderly patients who were first treatment because of depression should pay attention to the possibility of cerebral infarction ,and the symptoms of depression was related to infarction place ,combined diseases, life behavior and other factors.