卒中后抑郁与脑损伤部位相关性的临床研究

Clinical research of the relationship between post-stroke depression and the region of brain injury

目的探讨不同的脑损伤部位与脑卒中后抑郁病变的关系,探讨PSD的现况以及对结局的影响。方法收集2010年09月～2011年09月期间河北联合大学附属医院神经内科脑卒中患者300例,通过颅脑CT或MRI进行卒中病灶定位,采用Hamilton抑郁量表对卒中患者在发病14±2d及90±7d进行抑郁及程度的评价。对收集患者的相关临床指标如美国国立卫生院神经功能缺损评分(NIHSS)、改良Rankin量表评分(MRS)、简易精神状态检查表(MMSE)评分等相关因素进行统计分析。结果 140例脑卒中患者合并PSD,总发生率为46.67%,其中轻中度抑郁占46.00%,重度抑郁占0.67%;多发性、左侧半球、额颞叶、基底节区脑卒中患者PSD发生率高。结论脑卒中患者神经功能缺损程度评分越高,其患抑郁的程度也就越高。PSD发生与卒中类型无关,而与卒中部位、卒中残疾程度等因素有关。

Objective To explore the relationship between poststroke depression（PSD）and the region of brain injury,and to explore poststroke depression（PSD）of the current situation and the effect to prognosis.Methods 300 hospitalized patients with cerebral infarction were collected from the Department of Neurology,Affiliated Hospital of Hebei Unite University,during September 2010 to september 2011.Preoperative diagnosis was made by CT or MRI scan,on（14±2）d and（90±7）d,respecitively followed up after stroke were carried out.Post stroke depression（PSD）was considered to be present when either the Hamilton Depression Scale（HAMD）score were met.300 patients with stroke were accessed on clinical data（including the National Institute of Health Stroke Scale（NIHSS）,modified rainkin Scale（mRS）and minimental status examination（MMSE））and Hamilton Depression Rating scale（HAMD）in different course of disease,and analyzed for the correlation between the PSD and the region of brain injury.Results There were 140 cases with PSD in all the patients.The incidence rate was 46.67%.The minor and moderate cases incidence were 46.00%,severe cases incidence was 0.67%.The incidence of PSD was higher in the multiple stroke,left-hemisphere stroke,frontal-temporal stroke and basal ganglia stroke.Conclusion The higher degree of the neurological impairment score is,the deeper the degree of depression occurs.The important factors for PSD involves the region of stroke and the degree of the disability.It had no relation with type of stroke.