脑卒中后抑郁障碍的临床分析

Clinical analysis of post-stroke depression disorder

目的分析脑卒中后抑郁障碍(post-stroke depression disorder,PSDD)的发病相关因素。方法对入选的697例脑卒中患者的性别、年龄、脑卒中类型、脑卒中病灶部位、美国国立卫生研究院脑卒中量表(National Institutesof Health Stroke Scale,NIHSS)神经功能缺损程度评分、Barthel指数(BI)、汉密尔顿抑郁量表评分(HamiltonRating Scale for Depression,HAMD)进行记录,并对不同分类中PSDD发生率进行比较。结果脑出血PSDD发生率明显高于脑梗死PSDD发生率(26.6%vs 16.3%,x^2=6.48,P=0.01)。PSDD患者入院时NIHSS评分明显高于无PSDD患者[(6.00±4.60)分vs(4.52±3.74)分],BI评分明显低于无PSDD患者[(57.40±26.54)分vs(68.1 6±25.76)分],差异有统计学意义(P<0.01)。PSDD患者入院时NIHSS评分HAMD呈正相关(r=0.21,P<0.01),入院时BI评分与HAMD呈负相关(r=-0.18,P<0.01)。logistic回归分析显示,入院时BI评分是抑郁的保护因素(标准偏回归系数=-0.02,OR=0.98,95%CI:0.98～0.99,P<0.01)。结论 PSDD与脑卒中类型、入院时NIHSS评分及BI评分有关。

Objective To analyze the relative pathiogenetic factors for post-stroke depression disor- der（PSDD）. Methods Six hundred and ninety-seven cerebral stroke patients were enrolled in this study. Their gender,age,cerebral stroke type and foci,NIHSS score,Barthel index（BI） and Ham- ilton rating scale score were recorded. The incidence of different PSDD types was compared. Re- sults The incidence of cerebral hemorrhage was significantly higher in PSDD patients than in cerebral infarction patients at admission（26. 6± vs 16. 3%, x2 = 6. 48, P ~ 0. score was significantly higher while the BI was significantly lower in PSDD pat PSDD patients at admission（6.00±4.60 vs 4.52±3.74,57.40±26.50 vs 68 01）. The NIHSS ents than in non- 16±25. 76,P〈 0.01）. The NIHSS score was positively related while the BI was negatively related with the oc- currence of PSDD. Logistic regression analysis showed that the BI was a protective factor for PSDD（OR=0.98,95%CI：0.98--0.99,P〈0.01）. Conclusion PSDD is related with the stroke type,NIHSS score and BI.