脑卒中后急性期抑郁障碍相关因素分析

Study on the relative factors of post stroke depression in stroke acute phase

目的研究脑卒中后急性期抑郁障碍(post-strokedepression,PSD)与生物、心理及社会因素的关系。方法选择98例住院诊断为脑卒中后急性期患者作为研究对象,除评定一般自然状况外,采用汉密尔顿焦虑量表(HamiltonAnxietyScale,HAMA)、社会支持评定量表、领悟社会支持量表(PSSS)、改良爱丁堡斯堪的那维亚神经功能缺损评分量表、伴发疾病评分量表、艾森克个性问卷(EPQ)对入组病人进行评定,对所有病人进行脑CT扫描,神经元特异性烯醇化酶(NSE)检测。结果脑卒中后急性期PSD的发生率为41.84%。单因素分析显示脑卒中后急性期PSD的发病主要反映在病灶数量、病灶前后部位、病灶最前点到额极的距离、病灶最前点到额极的距离与额枕极距离的比值、神经功能缺损、伴发疾病评分、NSE值、HAMA分值、躯体焦虑分值、精神焦虑分值、PSSS分值、E分值、N分值、L分值、客观支持分值方面有差异。PSD组与对照组的多元Logistic逐步回归(前进法)分析显示PSD的发病主要与PSSS分值、HAMA分值、病灶最前点到额极的距离相关。结论脑卒中后急性期PSD的发病是生物、心理及社会等因素共同作用所致。

Objective Study the relationship between acute onset post stroke depression (PSD) and biologic, psycholgic and social factors. Method 98 inpatients with acute onset PSD were evaluated by Hamilton depression scale (HAMD),Hamilton anxiety scale ( HAMA), social support scale, Perceived social support scale ( PSSS), neurologic deficit scale, complication scale and eysenck personality questionnaire (EPQ).All the patients were made brain CT scan and tested NSE. Result The incidence rate of acute onset PSD was 41.84%.One way analysis indicated the differences of PSD exist in number of lesions, lesion location, the distance between the frontest point of foci and frontal pole, the ratio of the distance between the frontest point of foci and frontal pole to the distance from the frontal to occipital pole, scores of neurologic deficit, scores of complication, NSE values, HAMA scores, somato anxiety scores., mental anxiety score,PSSS scores, E values, N values, L values and objective support scores.Multiple logistic stepwise regression analysis (forward method) showed that PSD had significant correlation with PSSS scores, HAMA scores and the distance between the frontest point of foci and frontal pole.Conclusion Acute onset PSD is in relation to biologic, psychologic and social factors.