影响卒中后抑郁发生与程度的相关因素分析

Study on the Relative Factors of Incidence Rate and Degree of Poststroke Depression

目的：探讨卒中后抑郁（PSD）的发生率及影响PSD的相关因素。方法：325例首次脑卒中患者按汉密顿抑郁量表（HAMD）评分分为无抑郁障碍与抑郁两组，计算PSD的发生率，并比较两组患者之间的一般情况、血管性危险因素、脑卒中类型、发病部位、日常生活能力、神经功能缺损程度、社会支持度，了解影响PSD发生的相关因素。结果：PSD发生率为38．2％，其中轻度抑郁为26．5％，中重度抑郁为11．7％。抑郁组男性、中学或以上文化程度、家庭人均收入〉2000元／月的患者比例低于无抑郁障碍组（P〈0．05，P〈0．01）；抑郁组高血压、糖尿病、心脏病患者的比例高于无抑郁障碍组（P〈0．001，P〈0．05）；抑郁组ADL评分、社会支持度评分低于无抑郁障碍组（P〈0．001）；抑郁组NIHSS评分高于无抑郁障碍组（P〈0．001）。结论：PSD是脑卒中常见并发症，是一个多因素的结果，可能与患者性别、教育程度、经济情况、高血压、糖尿病、心脏病、日常生活能力、神经功能缺损程度、社会支持度密切相关。‘

Objective： To investigate the incidence rate of poststroke depression （PSD） and the relative factors of PSD. Methods： 325 patients with acute stroke were followed up by Hamilton De- pression Rating Scale （HAMD）, National Institutes of Health Stroke Scale （NIHSS）, Activities of Daily Living （ADL）, Social Support Scale （SSRS）, and a self-designed form. All cases were divided into two groups, non-PSD and PSD group based on HAMD score, the incidence rate of PSD was calculated. The data of the two groups were compared. Results： The incidence rate of PSD was 38.2%. The rate of low-degree PSD was 26.5%, and the rate of middle or above-degree PSD was 11.7%. Female, under middle school education, income less than 2000 yuan per family people per month, hypertension, diabetes, heat disease were more prevalent in the PSD group （P〈0.05, P〈0.01, P〈0.001）. The score of NIHSS was higher in PSD group （P〈0.001）, the scores of ADL and SSRS were higher in non-PSD group （P〈0.001）. Conclusion： PSD is a familiar complication of cerebro- vascular disease. It is a result of multiple factors, maybe immediately related to sex, education, fami- ly income, hypertension, diabetes, heat disease, activities of daily living, neurological deficits and social support.