出血性卒中后抑郁患者认知功能与生活质量的研究

Study on Cognitive Function and Quality of Life of Patients with Depression after Hemorrhagic Stroke

目的:探讨不同时期出血性脑卒中后抑郁(Post-Stroke Depression,PSD)患者认知功能和生活质量的特征。方法:采用前瞻性队列研究,对57例PSD患者和91例非PSD(None PSD,NPSD)患者在基线期、6周和12周后分别进行临床神经功能缺损程度评分量表(China Stroke Scale,CSS)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)和Barthel指数(Barthel Index,BI)的评估。结果:基线期PSD和NPSD患者Mo CA总分[分别为(11.6±2.9)分、(11.2±3.1)分]和BI总分[分别为(45.6±8.3)分、(46.2±7.2)分],差异无统计学意义(P>0.05);治疗6周和12周后PSD组Mo CA总分[分别为(13.4±2.3)分、(18.2±3.2)分]和BI总分[分别为(63.8±6.5)分、(77.2±4.1)分]均低于NPSD组[分别为(15.8±2.8)分、(22.6±2.4)分;(72.2±7.5)分、(85.8±5.6)分],差异有统计学意义(P<0.000)。结论:在卒中的康复后期,PSD患者较NPSD患者认知功能障碍损害更严重,生活质量更差。推测认知功能是PSD患者长期预后的独立预测因素,可为PSD患者康复策略的制定提供帮助。

Objective： To explore the characteristics of the cognitive function and quality of life in patients with depression after hemorrhagic stroke（Post-Stroke Depression, PSD） in different periods. Methods： Prospective cohort study of 57 PSD patients and 91 NPSD patients was designed and the data collection of China Stroke Scale（CSS）, Hamilton Depression Scale（HAMD）, Montreal Cognitive Assessment（Mo CA） and Barthel Index（BI） occurred during the intervention period at baseline, 6 weeks and 12 weeks. Results： The difference of the Mo CA scores and BI scores between PSD patient and NPSD patient at baseline was not statistically significant（11.6 ±2.9 vs 11.2 ±3.1, P〉0.05; 45.6 ±8.3 vs 46.2 ±7.2, P〉0.05 respectively）. While the Moca scores and BI scores of PSD patient after 6weeks and 12 weeks after treatment were significantly lower than NPSD patient（13.4±2.3 vs 15.8±2.8, P〈0.000; 18.2±3.2 vs 22.6±2.4, P〈0.000; 63.8±6.5 vs 72.2±7.5, P〈0.000; 77.2±4.1 vs 85.8±5.6, P〈0.000）. Conclusions： The cognitive function was speculated as an independent predictor factor of long-term prognosis of PSD patients, which could help to develop PSD rehabilitation strategies.