轻度认知功能障碍老年患者发生抑郁的危险因素分析

Analysis of Risk Factors for the Occurence of Depression in Senile Patients with Mild Cognitive Impairment

目的:研究轻度认知功能障碍(MCI)老年患者发生抑郁的危险因素。方法:选取2020年6月-2021年11月福建省福州神经精神病防治院老年科、神经内科和精神科门诊及住院部明确诊断为MIC患者109例。将所有患者进行抑郁诊断及分组,分为观察组(43例)、对照组(66例),同时收集其临床资料。对MIC抑郁发生的影响因素进行单因素及多因素分析。结果:两组年龄、性别、原职业、婚姻及教育程度、血清尿酸、血同型半胱氨酸水平、颈动脉粥样硬化、脑萎缩及脑沟、脑室增宽、糖尿病、高血压、冠心病、吸烟比较差异均无统计学意义(P>0.05)。观察组体重指数、血清总胆固醇水平、甲减及血脂异常占比均高于对照组,腔隙性脑梗死占比高于对照组(P<0.05)。Logistic回归分析显示,总胆固醇水平和腔隙性脑梗死是MCI发生抑郁的危险因素(P<0.05),结论:MCI患者发生抑郁的比例不低,应关注老年MCI患者腔隙性脑梗死的情况,选择健康的膳食结构,纠正高脂肪、高热量的饮食习惯,同时开展适宜的肢体活动锻炼。

Objective:To study risk factors for the occurence of depression in senile patients with mild cognitive impairment(MCI).Method:A total of 109 patients with MIC were selected from the Outpatient and Inpatient Departments of Geriatrics,Neurology and Psychiatry of Fuzhou Neuropsychiatric Prevention and Treatment Hospital in Fujian from June 2020 to November 2021.All patients were diagnosed for depression and grouped,there were 43 cases in observation group and 66 cases in control group,and their clinical data were collected at the same time.The influencing factors of the occurence of depression in MIC were analyzed by single factor and multi factor analysis.Result:There were no significant differences in age,sex,original occupation,marriage and education level,serum uric acid,blood homocysteine level,the proportions of carotid atherosclerosis,brain atrophy,widening of sulcus and ventricle,diabetes,hypertension,coronary heart disease and smoking between the two groups(P>0.05).The body mass index,serum total cholesterol level,the proportion of hypothyroidism and dyslipidemia in the observation group were higher than those in the control group,and the proportion of lacunar cerebral infarction was higher than that in the control group(P<0.05).Logistic regression analysis showed that total cholesterol level and lacunar cerebral infarction were the risk factors of the occurence of depression in MCI(P<0.05).Conclusion:The proportion of depression in MCI patients is not low,and it is necessary to pay attention to the situation of lacunar cerebral infarction in elderly MCI patients,choose a healthy dietary structure,correct high-fat,high-calorie eating habits,and carry out appropriate physical exercises.