缺血性卒中患者并发抑郁相关因素研究

Study on Related Factors of Depression in Patients with Ischemic Stroke

目的:分析缺血性卒中患者并发抑郁的相关因素。方法:使用汉密顿抑郁量表(HAMD)对100例脑梗死患者进行焦虑抑郁量表评分并作出诊断,采用ADL量表(Barthel指数)对所有患者进行日常生活自主活动能力评估,采用美国国立卫生研究院卒中量表(NIHSS)对所有患者进行神经功能缺损评定,抽取所有患者静脉血测定血浆同型半胱氨酸(Hcy)和超敏C-反应蛋白(hs-CRP)。结果:根据汉密顿抑郁量表(HAMD)评分结果将所有患者分为脑梗死抑郁组(n=58,PSD组)与脑梗死非抑郁组(n=42,NPSD组)。两组性别、Barthel指数、NIHSS评分、脑梗死急性期和脑梗死后6个月Hcy、hs-CRP比较,差异均有统计学意义(P<0.05)。Pearson相关分析显示Hcy、NIHSS评分与HAMD评分均呈正相关(P<0.05),Barthel指数与HAMD评分呈负相关(P<0.05)。经多元logsitic回归分析显示,女性、Barthel指数、NIHSS评分、Hcy均是PSD的独立影响因素(P<0.05)。结论:脑梗死后患者发生抑郁的独立影响因素有女性、Barthel指数、NIHSS评分、Hcy。

Objective:To study the related factors of depression in patients with ischemic stroke.Method:A total of 100 patients with cerebral infarction were scored and diagnosed with Hamilton depression scale,all patients were evaluated the autonomous activities of daily life with ADL scale(Barthel index).The National Institutes of Health Stroke Scale was used to assess neurological deficts in all patients.Plasma homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP)were measured in venous blood of all patients.Result:According to the results of Hamilton depression scale,all patients were divided into PSD group(n=58)and NPSD group(n=42).The gender,Barthel index,NIHSS score,Hcy and hs-CRP in acute cerebral infarction and 6 months after cerebral infarction of two groups compared,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that Hcy,NIHSS score and HAMD score were positively correlated(P<0.05),Barthel index and and HAMD score was negative correlated(P<0.05).Multivariate logsiticl regression analysis showed that Women,Barthel index,NIHSS score and Hcy were all independent influencing factors of PSD(P<0.05).Conclusion:The independent influencing factors for depression after cerebral infarction include Women,Barthel index,NIHSS score and Hcy.