高血压共病抑郁障碍患者执行功能特点研究

Executive function features of hypertension co morbid with depressive disorder

目的探讨高血压共病抑郁障碍患者的执行功能损害特点。方法将2013年1月至11月在北京大学精神卫生研究所门诊和住院患者分为4组,研究组为高血压共病抑郁40例,按性别、年龄、受教育程度匹配疾病对照组(包括高血压组35例,抑郁组32例)及健康对照组47例。所有受试者接受威斯康星卡片分类、Stroop色词干扰、连线测验、词语流畅性等神经心理学测验评估执行功能。结果威斯康星卡片分类测验中,高血压共病抑郁组的持续错误数明显多于高血压组、抑郁组和健康对照组(P<0.05),完成分类数在各组中最少,与健康对照组比较差异有统计学意义(P<0.05);Stroop色词干扰测验中,共病组Stroop-C的完成时间在各组中最长(P<0.05),正确数少于抑郁组和健康对照组(P<0.05),共病组Stroop-CW的正确数少于高血压组和健康对照组(P<0.05);词语流畅性测验中,共病组产生词汇量少于健康对照组(P<0.05);连线测验中,共病组的完成时间最长,错误数最多,但与对照组差异无统计学意义。结论高血压共病抑郁患者存在执行功能损害,其损害程度较抑郁障碍及高血压患者更明显。

Objective To study the executive function of patients with hypertension co morbid with depressive disorder.Methods A cross section study was performed among 150 subjects,which were divided into 4 groups,namely,co morbid group（n =40）,hypertension group（n =35）,depression group（n =32）,and healthy control group（n =47）. Between dif ferent groups,the subjects were matched with sex,age and years of education. All subjects received a battery of neuropsy chological tests,including Wisconsin Card Sorting Test（WCST）,Stroop color word test（Stroop C/ Stroop CW）,Trail Making Test（TMT）,and Verbal Fluency Test（VFT）. Results Wisconsin Card Sorting Test showed that co morbid group had more perseverative errors than all other groups（P 0.05）. On WCST numbers of categories,co morbid groups named significantly less than healthy control group（P 0.05）. The Stroop C complete time was longer in co morbid group than in the other three groups（P 0.05）,and the co morbid group had less correct responses on Stroop C test than depression group or healthy control group（P 0.05）. In co morbid group,Stroop CW correct responses were significantly higher in co morbid group than in hypertension group or healthy control group（P 0.05）. On VFT,total number was significantly less in the co morbid group than in the healthy control group（P 0.05）. On TMT,co morbid group used the longest time and made the most wrong responses,but these differences were not statistically significant when compared to the other three groups. Conclusion Executive function impairments were observed in patients of hypertension co morbid with depressive disorder. These impairments were even more marked than the simple hypertension group and the simple depression group.