脑卒中后抑郁与神经功能缺损关系研究

Study on the relationship between post-stroke depression and neurological deficits

目的探讨脑卒中后抑郁与神经功能缺损程度和日常生活活动能力的相关性。方法采用抑郁自评量表、汉密尔顿抑郁量表17项、美国国立卫生研究院卒中量表、Barthel指数对160例脑卒中患者进行抑郁、神经功能缺损和日常生活活动能力评价。结果 160例脑卒中患者中65例(40.63%)出现抑郁症状。与无抑郁组相比,抑郁组患者神经功能缺损程度更重(P=0.045)、日常生活活动能力更低(P=0.000)。进一步将脑卒中后抑郁患者分为轻度、中度和重度抑郁亚组,随着抑郁程度的增加,神经功能缺损加重(P=0.000,0.000,0.000)、日常生活活动能力下降(P=0.000,0.000,0.000)。Pearson相关分析显示,抑郁症状与神经功能缺损程度呈正相关(r=0.534,P=0.005),与日常生活活动能力呈负相关(r=-0.645,P=0.002)。结论脑卒中后抑郁与神经功能缺损程度和日常生活活动能力相关,积极治疗原发病、减轻神经功能缺损、早期康复治疗、提高日常生活活动能力,将有助于减轻脑卒中后抑郁程度。

ObjectiveTo explore the relationship of post-stroke depression（PSD） with neurological function deficits and activities of daily living.Methods A total of 160 patients with stroke from August 2012 to September 2013 in Department of Neurology in our hospital were enrolled. Self-Rating Depression Scale（SDS）, Hamilton Depression Rating Scale-17 Items（HAMD- 17）, National Institutes of Health Stroke Scale（NIHSS） and Barthel Index（BI） were used to assess depression, neurological function deficits and activities of daily living of stroke patients.ResultsA total of 65 patients（40.63%） appeared depression after stroke. Compared with non-PSD group, patients in PSD group presented more serious neurologicalfunction deficits（P = 0.045） and less activities of daily living（P = 0.000）. The PSD group was further divided into 3 subgroups： mild, moderate and severe depression. Along with the increase of severity of PSD, NIHSS score increased（P = 0.000, 0.000, 0.000） while Activities of Daily Living（ADL） score decreased（P = 0.000, 0.000, 0.000）. Pearson correlation analysis suggested that HAMD score was positively correlated with NIHSS score（r = 0.534, P = 0.005）, and negatively correlated with ADL score（r =- 0.645, P =0.002）.Conclusions PSD is closely related with the degree of neurological function deficits and activitiesof daily living. Curing the primary disease, reducing neurological dysfunction, taking early rehabilitation therapy, and improving the patients＇ activities of daily living will be helpful to alleviate the degree of PSD.