卒中后抑郁的研究进展

Research progress on post-stroke depression

卒中后抑郁(PSD)是指在明确的脑卒中事件(包缺血性脑卒中和出血性脑卒中)后出现的抑郁症状。PSD发生率高,诱因众多。PSD目前有短暂性抑郁、持续性抑郁状态和抑郁复发三种发作形式。PSD的发生机制具有多元论、多样化特点,目前主要集中于神经解剖学说、神经生化学说和神经基因遗传学说三个方面,且更倾向于上述几种发病机制共同作用出现的结果。PSD的治疗以脑卒中及其二级预防为首要治疗,专科医师积极心理辅导、家庭成员及社会关怀等不可或缺。新型选择性5-羟色胺再摄取阻滞剂能够有效改善患者抑郁症状,新的物理治疗方法及改良的红细胞生成素,也给卒中后抑郁的治疗带来新的机遇。

Post-stroke depression(PSD)refers to depressive symptoms that occur after definite stroke event(including ischemic stroke and hemorrhagic stroke).The incidence of PSD is high with many inducements.PSD has three episodes of transient depression,persistent depression and recurrent depression.The pathogenesis of PSD have the characteristics of pluralism and diversity.At present,it mainly concentrates on three aspects of aspectsneuroanatomy,neurobiochemistry and neurogenetics,and tends to be the result of the interaction of the three pathogenesis.The treatment of PSD is based on stroke and its secondary prevention.The active counseling of the specialists,family members and social care are indispensable.The new selective serotonin reuptake blocker can effectively improve the patient’s depressive symptoms,new physical therapy and improved erythropoietin,and also bring new opportunities for the treatment of post-stroke depression.