脑外伤所致抑郁障碍的影响因素分析

Analysis of influencing factors of depression in patients with cerebral trauma

目的探讨脑外伤后发生抑郁障碍以及抑郁症状严重程度的相关因素,为阐明其发病机制、筛选高危患者以及建立有效的干预措施提供理论依据。方法以安徽省某医院近3年因急性颅脑损伤住院治疗后出院的患者为研究对象,由2名精神科医师根据DSM-IV诊断标准诊断患者是否患有抑郁症,采用汉密顿抑郁量表(HAMD)评价研究对象抑郁程度,使用自行设计的问卷调查患者的一般情况和临床信息,采用多因素Logistic回归和多元线性回归分析脑外伤后发生抑郁障碍以及抑郁症状严重程度的相关因素。结果多因素Logistic回归结果显示:GCS评分、手术情况、脑干损伤以及残疾与脑外伤所致抑郁障碍有关联(P<0.05),GCS评分越高,发生抑郁障碍的风险越低,手术、脑干损伤以及残疾可导致脑外伤后发生抑郁障碍的风险增加。多元线性回归结果显示:GCS评分、手术情况以及残疾与脑外伤患者抑郁症状严重程度有关联(P<0.05),GCS评分越高抑郁症状越轻,手术和残疾可导致抑郁症状增加。结论 GCS评分、手术情况、脑干损伤以及残疾是脑外伤后抑郁障碍发生的影响因素,GCS评分、手术情况以及残疾是脑外伤患者抑郁症状严重程度的影响因素。

Objective To analyse the influencing factors of the occurrence and the severity of depression in patients with cerebral trauma,and to provide a theoretical basis for the pathogenesis and screening of patients at high risk for effective intervention measures.Methods Patients treated for acute cerebral trauma in a hospital of Anhui province in recent 3 years were collected.Psychiatrists diagnosed patients with depression according to DSM-IV and estimated the degree of depression with Hamilton Depression Rating Scale（HAMD）.The general condition of patients and clinical information were collected by a self-designed questionnaire,and the influencing factors of the occurrence and the severity of depression were analyzed by multivariate logistic regression and multiple linear regression.Results Multivariate logistic regression results detected the association between GCS score,operation,disability,brain stem injury and depression in patients with cerebral trauma（P＆lt;0.05）.GCS score was negatively associated with the risk of depression.Operation,brain stem injury and disability could increase the risk of depression.Multiple linear regression results detected the association between GCS score,operation,disability and the severity of depression in patients with cerebral trauma（P＆lt;0.05）.GCS score was negatively associated with the severity of depression.Operation and disability could increase the depressive symptoms.Conclusion The GCS score,operation,disability and brain stem injury are the influencing factors of depression in patients with cerebral trauma.GCS score,operation and disability are the influencing factors of the severity of depression in patients with cerebral trauma.