腔隙性脑梗死患者卒中后抑郁的临床分析

Clinical analyses of post-stroke depression in patients with lacunar infarction

目的探讨腔隙性脑梗死(腔梗)患者发生卒中后抑郁(PSD)的特点及其相关因素。方法138例经CT和MRI证实的腔梗患者根据Hamilton抑郁量表(HAMD)、抑郁自评量表(SDS)评分分为PSD组及非PSD组;分析梗死灶的部位、数量、患者年龄、文化程度、神经功能缺损程度评分、伴发疾病等对PSD的影响。结果本组PSD发生率为31.2%(43例);多为轻度抑郁,焦虑/躯体化症状为重;与非PSD组比较,PSD组患者年龄≥65岁、文化程度低、伴高血压病的比率以及神经功能缺损程度评分明显增高(P<0.01～0.001);神经功能缺损程度评分与PSD正相关(r=0.988,P<0.01)。梗死灶多发或位于丘脑、尾状核、豆状核的患者PSD发生率显著高于单梗死灶或其位于皮质下白质的患者(均P<0.01)。结论腔梗患者PSD多为轻度,焦虑/躯体化症状较重;PSD与病灶部位、病情以及文化程度等生物-心理-社会多因素有关。

Objective To explore the characteristics and related factors of post-stroke depression（PSD） in patients with lacunar infarction（LI）.Methods One hundred and thirty-eight LI patients confirmed with CT or MRI,were evaluated by Hamilton depression rating scale（HAMD） and Selfrating depression scale（SDS）,and divided into PSD group and non-PSD group.The influence factors on PSD including infarct lesion location and quantity,the patients＇ age,education,neurological deficits score and combined disease were analyzed.Results In this group,the incidence of PSD was 31.2%（43 cases）.Mostly of the depression was slightly and the main performance was anxiety/somatization.Compared with non-PSD group,the ratio of≥65 year old,the lower education level,combined hypertension and neurological deficits score in PSD group were significantly higher（P0.01-0.001）.The neurological deficits score was positive correlated with PSD（r=0.988,P0.01）.PSD ratio in patients with multiple infarct lesions or which located in the thalamus,caudate nucleus,lenticular nucleus were significantly higher than the patients with single infarct lesion or which located in subcortical white matter（all P0.01）.Conclusion PSD in LI patients mostly is slight.The common symptoms are anxiety/somatization.PSD may be associated with psychological biological-social factors,such as lesion location,condition of illness,education level and so on.