脑卒中伴不同程度抑郁患者的神经功能缺损、日常行为能力及认知功能分析

ANALYSIS ONNEUROLOGICAL DEFICIT,COGNITIVE FUNCTION AND ACTIVITY OF DAILY LIVING IN STROKE PATIENTS WITH DIFFERENT DEGREE OF DEPRESSION

目的：分析脑卒中伴不同程度抑郁患者的神经功能缺损程度、日常行为能力及认知功能的影响。方法：选择陕西省宝鸡市中心医院康复医学科2015年2月至2016年2月收治的脑卒中后抑郁患者100例,在病情稳定后对患者的心理、情绪状态进行评估,根据患者抑郁程度的不同分为轻度抑郁组[27例,汉密尔顿抑郁量表（HAMD量表）评分7~17分]、中度抑郁组（48例,HAMD量表评分18~24分）及重度抑郁组（25例,HAMD量表评分〉24分）,并对比3组脑卒中患者的神经功能缺损程度、认知功能及日常行为能力。结果：经对比,3组的脑卒中神经缺损程度（CNS量表）评分、认知功能（MMSE）评分和日常生活活动能力（ADL）评分比较存在差异统计意义（P〈0.05）,且随着抑郁程度增加,患者的CNS评分越高、ADL评分和MMSE评分越低。结论：脑卒中患者的神经缺损、认知功能、日常行为能力与患者的心理状态、抑郁程度具有密切相关性,在临床治疗中应采取综合性的心理干预治疗措施以预防抑郁发生、减轻抑郁程度,从而改善患者生活质量、促进预后康复。

Objective To analyze neurological deficit, cognitive function and activities of daily living （ADL）in stroke patients with different degree of depression. Methods： 100 cases of stroke patients with depressionin our hospital were selected and divided into mild depression group （ n =27 , HAMD score 7-17） , moderatedepression group （ n =48, HAMD score 18-24） and severe depression group （ n =25, HAMD score 〉24）. The neurological deficit, cognitive function and ADL were compared. Results： There were significantdifference in the scores of Canadian neurological scale （CNS）, mini mental state examination （MMSE） andADL among three groups （ P〈05）. There was a positive correction between depression degree and CNSscore, while the scores of ADL and MMSE had negative association with depression degree. Conclusion：Neurological deficit, cognitive function and ADL in stroke patients are closely related to their mental stateand severity of depression. The comprehensive psychological intervention measures should be conducted inclinic to prevent the occurrence of depression, reduce the severity of depression, and thus improve the qualityof life and prognosis.