首发脑卒中后不同时期抑郁的患病情况及相关因素分析

Analysis of Prevalence and Related Factors of Depression in Different Periods after First Stroke

目的分析脑卒中后不同时期抑郁的发生率,并探讨影响脑卒中抑郁发生的相关因素。方法便利收集2016年6月—2017年6月该院收治的急性脑卒中患者97例,分别于患者发病后第1、3、6、12个月采用汉密尔顿抑郁量表(HAMD)评估其抑郁情况。将发病后第12个月时32例HAMD评分≥8分的患者设为脑卒中后抑郁组,65例HAMD评分不足8分的设为非脑卒中后抑郁组。比较两组患者在年龄、性别、文化程度、脑卒中类型、病变部位、神经功能缺损评分、日常生活能力评分等方面的差异。结果 97例脑卒中患者发病后第1、3、6、12个月后抑郁的发病率分20.6%、30.9%、39.2%、33.0%;脑卒中后抑郁组和非脑卒中后抑郁组在年龄、性别、是否合并2种以上其他疾病、神经功能缺损评分、日常生活能力评分等方面差异有统计学意义(χ2年龄=4.961 0,χ2性别=4.593 0,χ2文化程度=0.483 5,χ2脑卒中类型=0.134 0,χ2合并2种以上其他疾病=29.737 7, t神经功能缺损评分=5.061 0,t日常生活能力评分=3.895 1,P<0.05);多因素logistic回归分析结果显示,合并2种以上其他疾病、神经功能缺损评分、日常生活能力评分是脑卒中后抑郁发生的独立影响因素。结论脑卒中后抑郁的发病率较高,以轻、中度抑郁为主,在临床诊疗中,应加强对低水平日常生活能力、伴严重神经功能缺损、合并多种疾病患者的监护。

Objective To analyze the incidence of depression in different periods after stroke and to explore the related factors affecting the occurrence of stroke depression. Methods 97 patients with acute stroke admitted to our hospital from June 2016 to June 2017 were convenient selected enrolled. The Hamilton Depression Scale (HAMD) was used to assess depression in the first, third, sixth and twelfth months after onset. At the 12 th month after onset, 32 patients with a HAMD score of ≥8 were assigned to the post-stroke depression group, and 65 patients with a HAMD score of less than 8 were assigned to the non-post-stroke depression group. The differences in age, gender, education level, stroke type, lesion location, neurological deficit score, and daily living ability score were compared between the two groups. Results The incidence of depression after the first, third, sixth and twelve months after the onset of stroke in 97 patients was 20.6%, 30.9%, 39.2%, and 33.0%. The post-stroke depression group and the non-post-stroke depression group were significantly different in age, gender, combined with more than 2 other diseases, neurological deficit scores, and daily living ability scores (χ^2 age = 4.961 0,χ^2 gender = 4.593 0,χ^2 education level = 0.483 5,χ^2 stroke type=0.134 0,χ^2 combined with more than 2 other diseases = 29.737 7, t neurological deficit score = 5.061 0, t daily living ability score = 3.895 1, P<0.05);multivariate Logistic regression analysis showed that more than 2 other diseases, nerves functional impairment scores and daily living ability scores were independent influencing factors of post-stroke depression. Conclusion The incidence of post-stroke depression is high, mainly mild to moderate depression. In clinical diagnosis and treatment, the monitoring of low-level daily living ability, severe neurological deficit, and patients with multiple diseases should be strengthened.