不同脑梗死分型与脑卒中后抑郁和认知功能障碍的关系研究

Study on the relationship between different types of cerebral infarction with PSD and cognitive dysfunction

目的探讨不同脑梗死分型与脑卒中后抑郁(PSD)和认知功能障碍的关系。方法选取2015年1月至2016年2月脑梗死患者110例,其中PSD患者47例,非PSD患者63例,采用汉密尔顿抑郁量表(HAMD)和简易智能状态检查量表(MMSE)进行评分。脑梗死分型采用牛津郡社区脑卒中项目(OCSP)分型方法,其中部分前循环梗死(PACI)32例,腔隙性梗死(LACI)48例,后循环梗死(POCI)30例。观察不同脑梗死分型患者的PSD发生情况和MMSE评分,比较PSD患者与非PSD患者的MMSE评分。结果 PACI型患者中PSD比例为78.13%,明显高于LACI和POCI型患者,差异有统计学意义(P<0.05);LACI和POCI患者PSD比例比较差异无统计学意义(P>0.05);PACI型患者MMSE评分为(24.05±3.11)分,低于LACI和POCI型患者(P<0.05);LACI和POCI型患者MMSE评分比较差异无统计学意义(P>0.05);PACI发生认知功能障碍比例为12.50%,LACI为14.58%,POCI为13.33%,差异无统计学意义(P>0.05);PSD患者MMSE评分为(23.13±2.17)分,低于非PSD患者,差异有统计学意义(P<0.05)。结论部分前循环梗死患者PSD发生率较高,认知功能受损较腔隙性梗死和后循环梗死明显;脑梗死患者抑郁情感障碍与认知功能损害可能相互影响。

Objective To investigate the relationship between different types of cerebral infarction with post stroke depression （PSD） and cognitive dysfunction.Methods 110 cases of cerebral infarction treated from January 2015 to February 2016 were selected, including 47 cases of PSD patients, 63 cases of non PSD patients.Hamilton Depression Scale （HAMD） and mini mental state estimate （MMSE） were used to score.Cerebral infarction was classified by Oxford County Community Stroke Project （OCSP）, including 32 cases of partial anterior circulation infarction （PACI）, 48 cases of lacunar infarction （LACI）, and 30 cases of posterior circulation infarction （POCI）.The PSD and MMSE scores of patients with different cerebral infarction were observed, and the MMSE scores of PSD patients and non-PSD patients were compared.Results The proportion of PSD in PACI patients was 78.13%, which was significantly higher than the LACI and POCI patients, the difference was statistically significant （P〈0.05）.The PSD proportional of LACI and PCI patients has no significant difference （P〉0.05）;MMSE score of PACI patients was （24.05±3.11） points, lower than that of POCI and LACI patients （P〈0.05）;MMSE scores of LACI and POCI patients had no significant difference （P〉0.05）.Incidence of cognitive dysfunction of PACI patients was 12.50%, LACI 14.58%, POCI 13.33%, the differences were not statistically significant （P〉0.05）.MMSE score of PSD patients was （23.13±2.17） points, lower than that of non PSD patients, the difference was statistically significant （P〈0.05）.Conclusion The incidence of PSD in partial anterior circulation infarction patients is higher, the cognitive dysfunction of patients are more significant than patients with lacunar infarction and posterior circulation infarction significantly;depression and cognitive impairment may affect each other in cerebral infarction patients.