抑郁障碍对颅脑创伤患者反应抑制功能的影响

Effect of depression on response inhibition of patients after traumatic brain injury

目的初步探讨抑郁障碍对颅脑创伤患者反应抑制功能的影响。方法采用Glasgow昏迷量表、汉密尔顿抑郁量表17项(HAMD-17)和日常生活活动能力量表(ADL)评价104例颅脑创伤患者(伴抑郁障碍54例、不伴抑郁障碍50例)颅脑创伤和抑郁障碍严重程度,刺激-反应相容性试验记录反应抑制任务反应时间。结果颅脑创伤伴抑郁障碍组HAMD-17(P=0.000,0.000)和ADL(P=0.000,0.000)评分高于颅脑创伤不伴抑郁障碍组和对照组,颅脑创伤不伴抑郁障碍组HAMD-17(P=0.000)和ADL(P=0.000)评分亦高于对照组。无论执行相容性还是不相容性任务,颅脑创伤伴或不伴抑郁障碍组患者反应时间均长于对照组(P=0.000,0.000),颅脑创伤伴抑郁障碍组患者反应时间亦长于颅脑创伤不伴抑郁障碍组(P=0.000)。结论颅脑创伤后可发生认知功能障碍,且在伤后6个月或更长时间仍存在。颅脑创伤伴抑郁障碍可以加重患者认知功能障碍,应早期识别并及时干预。

Objective To investigate the effect of depression on response inhibition of patients after traumatic brain injury(TBI).Methods Glasgow Coma Scale(GCS),Hamilton Depression Rating Scale-17 Items(HAMD-17) and Activities of Daily Living(ADL) were used to assess the severity of trauma,depression and activities of daily living in 104 TBI patients(54 with depression and 50 without depression).Besides,51 normal controls with matched age,sex and education were enrolled.Stimulus- Response Compatibility(SRC) task was employed to record the reaction time(RT) of response inhibition of the subjects in 3 groups.Results Both HAMD- 17 and ADL scores in TBI with depression group were significantly higher than those in TBI without depression group(P = 0.000,0.000) and normal control group(P = 0.000,0.000).Besides,HAMD-17 and ADL scores in TBI without depression group were significantly higher than those in normal control group(P = 0.000,0.000).Compared with normal control group,no matter in compatible or incompatible condition,RT was significantly longer in both TBI groups(P = 0.000,0.000).RT was much longer in TBI with depression group than that in TBI without depression group(P =0.000).Conclusions Cognitive dysfunction is a common symptom after TBI,which may exist 6 months after injury or even longer.TBI combined with depression could aggravate the impaired cognitive function,so early identification and timely intervention is very important.