脑卒中患者出现抑郁症状的影响因素分析

Study on the related factors of depressive symptoms of stroke

目的探讨引起脑卒中抑郁症状(PSD)的影响因素。方法对170例脑卒中患者采用抑郁自评量表(SDS)评估PSD发生情况,比较PSD组与非PSD组患者年龄、学历、性别、脑卒中次数、类型、工作、经济负担、家庭支持、脑卒中位置及医患关系、医疗费用、神经功能缺损等资料的差异。结果170例脑卒中患者SDS评分(56.76±12.67)分,PSD为50例(29.42%)(轻度PSD 20例,中度PSD 21例,重度PSD 9例)。PSD组年龄>90岁68.00%,低学历90.00%,复发型脑卒中28.00%,多发脑卒中26.00%,体力活动72.00%,经济负担重30.00%,缺少家庭支持18.00%,脑卒中位置大脑左半球56.00%,医患关系一般36.00%,自费18.00%,神经功能缺损84.00%,均高于非PSD组比例(P<0.05)。Logistic回归分析引起PSD因素:年龄>90岁(OR=4.71,95%CI:1.31~26.34)、神经功能缺损(OR=4.40,95%CI:1.14~24.28)、低学历(OR=3.65,95%CI:1.09~19.17)、医患关系一般(OR=3.12,95%CI:1.17~18.24)。结论PSD发生率较高,是各因素共同作用的结果,应引起高度重视,尽早进行影响因素评估,实施针对性预防措施,降低PSD的产生。

Objective To explore the related factors of depressive symptoms of stroke(PSD).Methods Stroke patients 170 cases were assessed by(SDS),and the data of age,education,gender,stroke frequency,stroke type,work situation,economic burden,family support,relationship between doctors and patients in stroke location,medical expenses,neurological deficit were compared between PSD group and non PSD group.Results 170 stroke patients SDS score(56.76±12.67),PSD 50 cases(29.42%)(mild PSD 20 cases,moderate PSD 21 cases,severe PSD 9 cases).PSD group age>70 years 68.00%,low education 90.00%,recurrent stroke 28.00%,multiple stroke 26.00%,physical activity 72.00%,economic burden 30.00%,lack of family support 18.00%,location of stroke in left hemisphere e56.00%.Relationship between doctors and patients 36.00%,own expense18.00%,neurological deficit 84.00%,significantly higher than the proportion of non PSD group(P<0.05).The factors of PSD caused by logistic regression analysis:age>70 years old(OR=4.71,95%CI:1.31~26.34),Neurological deficit(OR=4.40,95%CI:1.14~24.28),Low education(OR=3.65,95%CI:1.09~19.17),The doctor-patient relationship was general(OR=3.12,95%CI:1.17~18.24).Conclusion The high incidence of PSD is the result of the joint action of various factors,which should be paid more attention to.The assessment of influencing factors should be carried out as early as possible,and targeted preventive measures should be implemented to reduce the generation of PSD.