脑卒中后焦虑相关因素分析

Research on related factors of poststroke anxiety

目的:探讨脑卒中后焦虑(PSA)的相关因素。方法:采用美国精神障碍诊断与统计手册第5版中文版“由于其他躯体疾病所致的焦虑障碍”的诊断标准,以及汉密尔顿焦虑量表-14项评价焦虑程度,对符合纳入标准的162例脑卒中患者记录其性别、年龄、体质指数、受教育年限、婚姻状况、既往史(高血压、糖尿病、高脂血症、心脏病、吸烟史、饮酒史)、脑卒中家族史,检测血清同型半胱氨酸水平,行头部CT和(或)MRI检查明确脑卒中类型、病灶部位和病灶数目;单因素和多因素Logistic回归分析脑卒中后焦虑的危险因素。结果:162例患者中有41例被诊断为卒中后焦虑,PSA总发生率为25.3%,以轻中度PSA常见。单因素分析发现:性别、吸烟史、卒中次数、卒中性质、病灶数目、NIHSS分值是PSA的相关因素。多因素Logistic回归分析显示:卒中次数(P=0.018)、病灶数目(P=0.011)、NIHSS分值(P=0.021)是PSA的独立危险因素。结论:卒中次数、病灶数目和NIHSS分值是PSA的独立危险因素。

Objective:To explore the related factors of poststroke anxiety(PSA).Methods:Diagnostic criteria of“Anxiety Due to Other Physical Diseases”from Chinese version of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-Ⅴ)and Hamilton Anxiety(HAMA-14 Items)Rating Scale were used to evaluate the degree of anxiety.A total of 162 stroke cases all met the inclusion criteria.The clinical data[sex,age,body mass index(BMI),education,marital status,medical history(hypertension,diabetes,hyperlipemia,heart disease,smoking history and drinking history)and family history of stroke]of the 162 stroke patients were recorded.Serum homocysteine(Hcy)level was examined.Head CT and/or MRI were used to indicate stroke subtype,site of lesions and number of lesions.Univariate and multivariate logistic regression analysis were used to screen related factors for PSA.Results:Among 162 cases,41 cases were diagnosed as PSA(25.3%),and most of them were mild to moderate anxiety.There were significant differences in sex,smoking history,number of strokes,nature of stroke,number of lesions and NIHSS scores between PSA group and non-PSA group.Univariate multivariate logistic regression analysis showed number of strokes(P=0.018),number of lesions(P=0.011)and NIHSS scores(P=0.021)were independent risk factors for PSA.Conclusion:number of strokes,number of lesions and NIHSS scores are independent risk factors for PSA.