急性缺血性脑卒中后焦虑状态的危险因素分析

Risk factors of anxiety state after acute ischemic stroke

目的探讨急性缺血性脑卒中后焦虑状态的发生率及其危险因素。方法前瞻性收集急性缺血性脑卒中发病后7 d内入院患者的临床资料,共纳入439例,男281例、女158例;年龄范围35~82岁,年龄为(62.26±10.98)岁,相关量表平均评估时间为发病后(83.27±26.45)h。符合急性缺血性脑卒中后焦虑状态122例,归入焦虑组,另317例归入非焦虑组。分析急性缺血性脑卒中后焦虑的发生与性别、年龄、文化程度、家庭收入、吸烟史、饮酒史、高血压、糖尿病史、高脂血症史、卒中史、卒中部位、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、Barthel指数(BI)、24项汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、简易智能精神状态检查表(minimum mental state examination,MMSE)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)等因素的相关性。结果急性缺血性脑卒中后焦虑状态的发生率为27.8%。两组患者的性别和高脂血症史构成比,以及NIHSS、HAMD、MMSE评分和PSQI、BI数值的差异均有统计学意义(P<0.05或0.01),两组患者额叶、颞叶、岛叶梗死构成比的差异均有统计学意义(P值均<0.05)。多因素logistic回归分析显示:性别为女性、NIHSS和HAMD评分增高、BI降低、额叶梗死是急性缺血性脑卒中后焦虑状态发生的独立危险因素。结论急性缺血性脑卒中后患者焦虑状态的发生率较高,性别、NIHSS评分、HAMD评分、BI、额叶梗死与急性缺血性脑卒中后焦虑状态独立相关。

Objective To investigate the incidence and risk factors of anxiety after acute ischemic stroke.Methods Patients admitted to hospital within 7 days after onset of acute ischemic stroke were prospectively collected and divided into anxiety group and non-anxiety group according to Hamilton anxiety scale(HAMA)score at admission.A total of 439 patients were enrolled in this study.There were 281 males and 158 females with a mean age of(62.26±10.98)years(range,35-82 years).They were evaluated at(83.27±26.45)h with seales after stroke.Of them,122 were assigned to anxiety group and 317 into non-anxiety group.The relationship between anxiety and gender,age,education level,family income,smoking,drinking,hypertension,diabetes,hyperlipidemia,stroke history,stroke location,National Institute of Health stroke scale(NIHSS),Barthel index(BI),24 Hamilton depression scale(HAMD),minimum mental state examination(MMSE),Pittsburgh sleep quality index(PSQI)were analyzed.Results The incidence of anxiety after acute ischemic stroke was 27.8%.There were significant differences in gender,hyperlipidemia history,NIHSS,HAMD,MMSE,PSQI,BI and the infarction percentage of frontal lobe,temporal lobe and insular lobe between the two groups(P<0.05 or 0.01).Logistic regression analysis showed that gender,NIHSS,HAMD,BI and frontal lobe infarction were independently associated with anxiety after acute ischemic stroke.Conclusion There is a high incidence of anxiety in patients with acute ischemic stroke.Gender,NIHSS,HAMD,BI and frontal lobe infarction are independently associated with anxiety after acute ischemic stroke.