脑卒中后情感淡漠与执行功能障碍、抑郁的相关性分析

Post Stroke Apathy is Correlated with Executive Dysfunction and Depression

目的:探讨急性脑卒中患者卒中后情感淡漠的发生,评价卒中后情感淡漠与抑郁、认知功能障碍、执行功能障碍的关系。方法:连续搜集于住院治疗的符合入组标准的急性脑卒中患者,采用淡漠评定量表-临床医生使用版本(AES-C)于起病后第2周对患者进行评估,根据有无伴发情感淡漠,将患者分为两组,比较两组间临床资料、MoCA、MMSE、HAMD、MDRS I/P评分是否存在显著性差异。评价AES-C评分和情感、认知、执行功能量表评分的相关性。结果:共有65例患者入组,其中22例(33.8%)患者存在情感淡漠症状。伴情感淡漠组患者MDRS I/P评分明显低于无伴情感淡漠组(25.2±2.5 vS.31.9±5.0 P<0.01),Pearson相关分析显示AES-C评分与MDRS I/P评分成负相关(r=-0.54,P<0.01),AES-C评分评分与HAMD评分成正相关(r=0.27,P=0.03)。结论:卒中后情感淡漠的严重程度与抑郁程度、执行功能障碍程度明显相关。

Objective： To study the incidence of post-stroke apathy in acute stroke patients. To analyze the correlation between apathy and other neuropsychological disturbances （including depression, cognitive impairment and executive dysfunction）. Methods： Acute stroke patients who met the criteria for inclusion were selected consecutively. Apathy evaluation scale-clinician version （AES-C） was assessed and the patients were divided into two groups （with apathy vs. without apathy）. The clinical characteristics and results of Montreal Cognitive Assessment （MoCA）, Mini Mental State Examination（MMSE）, Hamilton Depression Scale （HAMD） and Mattis Dementia Rating Scale initiation/ perseverence subscale （MDRS I/P） were compared between the two groups. The correlation between AES-C scores and results of MoCA, MMSE, HAMD and MDRS I/P were analyzed. Results： A total of 65 acute stroke patients were included. 22 patients （33.8%） met the diagnosis criteria of apathy. The MDRS I/P. scores in stroke patients with apathy were significantly lower than those in stroke patients without apathy （25.2±2.5 vs. 31.9±5.0 P〈0.01）. Pearson correlation analysis showed a negative correlation between AES-C scores and MDRS I/P scores （r=-0.54,P〈0.01）. A significant positive correlation was found between AES-C scores and HAMD scores （r=0.27,P=0.03）. Conclusion： The severity of apathy had a significant correlation with the severity of depression and executive dysfunction.