脑卒中所致的抑郁与血管性痴呆的分析——附84例报告

An analysis of stroke-related depression and vascular dementia: a report of 84 cases

目的:探讨脑卒中所致抑郁、血管性痴呆的发生率及其与临床类型、病情程度、脑卒中发作次数的关系。方法:应用Zung抑郁自评量表SDS、简易智能状态检查表MMSE、Hachinski缺血计分、神经功能测试量表对84例脑卒中患者进行调查。结果:脑卒中后抑郁发生率为44%,痴呆发生率为23%,两者有显著性差异P<0.05,两者共患率为17%。神经功能缺损越严重,抑郁、血管性痴呆的发生率就越高均为P<0.05;多发性脑梗死组的血管性痴呆发生率高于其他脑梗死组均为P<0.05。复发性脑卒中患者的抑郁与血管性痴呆发生率显著高于初发者均为P<0.01。结论:抑郁和血管性痴呆在脑卒中患者中较常见,其发生率与神经功能缺损程度、临床类型、脑卒中反复发作有关,抑郁的发生率比血管性痴呆高,两者有较高的共患性。应加强两者的早期的甄别,以便有效地预防和治疗。

ObjectiveToinvestigatetheprevalenceofstrokerelateddepressionandvasculardementiaandtherelationshipbetweenstrokeanddepressionordementia.Methods84patientswithstrokeweretestedwithZungselfratingdepressionscaleSDSminimentalstatusexaminationMMSEHachinskiischemiascoreandneurofunctiontestscale.ResultsTheprevalencesofdepressionandvasculardementiawere44%and23%respectively.TherewassignificantdifferenceinprevalenceofdepressionanddementiaP<0.05.Thecoexistentrateofthetwodiseaseswas17%.Themoresevereimpairmentofneurofunctionthehigh-erprevalencesofdepressionandvasculardementiaP<0.05P<0.05.TheprevalenceofvasculardementiawashigherinpatientswithmultiplecerebralinfarctionthaninsubjectswithunifocalorlacunasinfarctionP<0.05.Andalsotheprevalencesofdepres-sionandvasculardementiawerehigherinpatientswithrecurrentstrokethaninnewonsetsubjectsP<0.01P<0.01.Conclu-sionDepressionandvasculardementiaarecommoninpatientswithstroke.Theprevalencesofthetwodiseasesarecorrelatedwiththeseverityofneurofunctionimpairmentclinicaltypesandrecurrenceofstroke.Theprevalenceofdepressionishigherthanthatofvasculardementia.Thecoexistentrateofthetwodiseasesisratherhigh.Earlydiagnosisofthediseasesisbeneficialtoeffectivepre-ventionandtreatment.