脑卒中后抑郁患者的心理状况及其与认知功能的相关性

Psychological assessment of patients with post-stroke depression and its relationship with cognitive function

目的分析脑卒中后抑郁患者的心理状况及其与认知功能的相关性,为患者的诊断提供指导。方法选取惠州市中心人民医院2017年3月至2019年10月收治的110例脑卒中后抑郁患者作为研究组,采用汉密尔顿抑郁量表(HAMD)评估患者的抑郁程度,并按照评估结果将其分为轻度组(86例)和重度组(24例);选择我院同期收治的50例脑卒中非抑郁患者作为对照组,采用蒙特利尔认知功能评估量表(MOCA)对全部患者的认知功能进行评估;比较评估结果,分析心理状况与认知功能的相关性。结果轻度组和重度组患者的MOCA评分分别为(19.52±3.06)分、(14.24±2.12)分,明显低于对照组的(24.24±5.16)分,且重度组的MOCA评分明显低于轻度组,差异均有统计学意义(P<0.05);轻度组和重度组患者的认知功能障碍发生率分别为26.74%、54.17%,明显高于对照组的6.0%,且重度组的认知功能障碍发生率明显高于轻度组,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,抑郁与认知功能评分呈负相关(r=-0.368,P<0.05)。结论脑卒中后抑郁患者的认知功能障碍明显加重,抑郁与认知功能障碍呈负相关,临床中需密切关注患者的心理及认知功能状况。

Objective To analyze the psychological status of patients with post-stroke depression and its correlation with cognitive function,so as to provide guidance for the diagnosis of patients.Methods A total of 110 patients with post-stroke depression admitted to Huizhou Central People's Hospital from March 2017 to October 2019 were selected as the study group,and Hamilton Depression Scale(HAMD)was used to evaluate the degree of depression of the patients.According to the evaluation results,the patients were divided into mild group(86 cases)and severe group(24 cases).Fifty patients of stroke without depression admitted to the hospital at the same time were selected as the control group.The cognitive function of all subjects was assessed by the Montreal Cognitive Assessment(MoCA),and the correlation between psychological status and cognitive function was analyzed.Results The MoCA scores of mild group and severe group were 19.52±3.06 and 14.24±2.12,respectively,which were significantly lower than 24.24±5.16 of the control group,and the MoCA score of severe group were significantly lower than that of mild group(P<0.05).The incidence of cognitive dysfunction in mild group and severe group were 26.74%and 54.17%,respectively,which were significantly higher than 6.0%of the control group,and the incidence in the severe group was significantly higher than that in the mild group(P<0.05).Spearman correlation analysis showed that depression was negatively correlated with cognitive function score(r=-0.368,P<0.05).Conclusion Post-stroke depression can aggravate cognitive dysfunction,and there is a negative correlation between the two.Close attention should be paid to the psychological and cognitive function of patients in clinic.