卒中后抑郁状态的相关因素及治疗

Related Factors and Therapy of Post Stroke Depression

目的 研究脑卒中后抑郁状态 (PSD)的发生率、相关因素及百优解的治疗效果。方法 对 36 4例脑卒中患者用欧洲卒中量表、Zung量表、HAMD抑郁量表进行评定及一般情况进行调查分析 ,对 Zung评分 >40及 HAMD>8分的患者服用百优解治疗 ,治疗前欧洲卒中量表评分为 30 .8± 6 .1,治疗 4周后再进行 Zung量表、HAMD、欧洲卒中量表评分。结果 PSD发病率 38. 1% ,对 PSD有影响的因素是脑卒中的部位、数量、神经功能缺损程度 ,既往有抑郁史、合并多种疾病、有无家人照料以及性别文化程度等。所有 PSD患者服用百优解治疗 4周后 ,HAMD <8分或 Zung<40分92例 ,减少 5分以上者 34例 ,治愈好转率为 90 .6 % ,欧洲卒中量表评分为 2 0 .4± 5 .4。结论 上述因素与 PSD密切相关 ,应注意预防 ,百优解治疗 PSD有效。

Objective To study incidence,related factors and fluoxetine therapy of post stroke depression.Methods Europe Stroke Scale,Zung Scale and Hamilton Depression Scale (HAMD) were conducted in 364 patients with stroke.Pa tients whose Zung scores were greater than 40 and HAMD scores greater than 8 were treated with fluoetine.Europe Stroke Scale score was 30.8±6.1 before treatment,and was assessed again by Zung Scale,HAMD,Europe Stroke Scale four week later.Results The incidence of post stroke depression was 38.1 percent, and the influence factors of post stroke depression included site and number of stroke,nervous function defect degree,history of depression,complicating multiple disease,care,sex,education degree.Among all patients with post stroke depression treated with fluoxetine,there were 92 cases whose HAMD scores were less than 8 or Zung scores less than 40,34 cases whose HAMD scores or Zung scores reduced by more than 5 points. The care rate was 90.6%,and Europe Stroke Scale score was 20.4 ±5.4.Conclusion We should alert to prevent related fators mentioned above,and fluoxetine was effective when treating post stroke depression.