卒中后抑郁瞬目反射改变的探讨

Changes of Blink Reflex in the Patients with Post- stroke Depression

目的：探讨卒中后抑郁（PSD）患者瞬目反射（BR）的改变。方法：选取2012年3月～2014年3月于我科住院脑卒中患者。脑卒中诊断符合1995年全国第4届脑血管病学术会议制定的脑卒中诊断标准。抑郁症诊断符合中国精神疾病分类方案与诊断标准第3版修订本（CCMD-3），在发病第2周时进行诊断，同时进行汉密尔顿抑郁量表（Hamilton depression rating scale，HAMD）24项版及Zung自评抑郁量表（Self—rating Depression Scale，SDS）评估，人组标准为分值分别大于20分和50分的患者。健康对照组的入选标准：门诊体检健康群众。各组患者分别进行BR测定，记录潜伏期进行比较分析。结果：150例脑卒中患者中HAMD评分大于20分者70例，PSD发生率为46．66％。脑卒中无抑郁组与健康对照组相比，BR潜伏期差异有统计学意义（P〈0．05）。脑卒中后抑郁组与健康对照组相比，BR潜伏期差异有统计学意义（P〈0．05）。脑卒中后抑郁组与脑卒中后无抑郁组相比，BR潜伏期差异有统计学意义（P〈0．05）。结论：脑卒中患者BR检测存在异常。2、脑卒中后抑郁组较之健康对照组，其BR潜伏期延长，差异有统计学意义。3、脑卒中后抑郁组较之脑卒中无抑郁组，其BR潜伏期延长，差异有统计学意义。

OBJECTIVE ： To explore the changes in the characteristics of blink reflex （BR） in the patients with post - stroke depression and to provide an objective basis for the early diagnosis of PSD. METHODS： Stroke patients who were in our hospital from March 2012 to March 2014 were selected. Diagnosis of cerebral apoplexy meeted the diagnostic criteria for the diagnosis of stroke made in the 4th National Conference on the development of cerebrovascular disease in 1995. Depression diagnosis also meeted China classification and diagnostic criteria revised 3rd edeition （ CCMD - 3 ）. The disease was diagnosed at the incidence after the second week and at the same time the Hamilton Depression Rating Scale （Hamihon depression rating scale, HAMD） version 24 and Zung self- rating depression Scale （ Self - rating Depression Scale, SDS） were assessed. BR was measured in each group separately. Incubation peri- od was recorded and analyzed. RESULTS： HAMD score of 70 eases among 150 stroke patients were more than 20 points. Compared with the healthy control group, there was statistically significant differences in BR lateneies in stroke without depression group （P 〈 0.05 ）. Compared with the healthy control group, there was statistically significant differences in BR latencies in post - stroke depression group （P 〈 0. 05 ）. Compared with the post - stroke ones in depression group there was statistically differences in BR in depression in stroke group （P 〈 0.05）. CONCLUSION ： In stroke group BR detect has anomalies. BR detect in post - stroke depression group has longer latent period compared with the healthy control group. BR detect in stroke after depression group has longer latent period than that in the group without depression.