脑血管疾病致脑卒中后抑郁的影响因素与影像学特征分析

Influencing factors and imaging features of post-stroke depression caused by cerebrovascular disease

目的 分析脑血管疾病致脑卒中后抑郁(PSD)的影响因素与影像学特征。方法 选择100例脑血管疾病患者,根据HAMILTON抑郁量表标准分为脑卒中后抑郁组(45例)和脑卒中后非抑郁组(55例)。分析脑卒中后抑郁与患者基本资料和影像学资料的关系;比较不同部位脑卒中后HAMILTON抑郁量表评分。结果 脑卒中后抑郁组患者合并高血压和糖尿病、失眠、失语及美国国立卫生研究院卒中量表(NIHSS)评分>15分的比例分别为48.89%、55.56%、82.22%、77.78%、80.00%,均高于脑卒中后非抑郁组的16.36%、20.00%、43.64%、40.00%、43.64%,差异有统计学意义(P<0.05)。失眠、NIHSS评分>15分是脑卒中后抑郁的独立危险因素(P<0.05)。两组患者病灶数量、病灶体积、脑前后部、脑萎缩比较,差异有统计学意义(P<0.05)。额叶和颞叶HAMILTON抑郁量表评分分别为(24.21±4.26)、(23.25±3.32)分,均明显高于基底节区的(14.50±4.15)分和小脑的(14.26±3.35)分,差异有统计学意义(P<0.05);额叶和颞叶HAMILTON抑郁量表评分比较,差异无统计学意义(P>0.05)。结论 脑血管疾病致脑卒中后抑郁发生与失眠、神经功能受损有关。脑卒中后抑郁的影像学特征突出,脑卒中部位(额叶和颞叶)、病灶多发、体积大与脑卒中后抑郁的发生密切相关。

Objective To analyze the influencing factors and imaging features of post-stroke depression(PSD) caused by cerebrovascular disease. Methods A total of 100 patients with cerebrovascular disease were selected and divided into post-stroke depression group(45 cases) and post-stroke non-depression group(55 cases) according to the criteria of HAMILTON depression scale. The correlation between post-stroke depression and patients’ basic data and imaging data was analyzed;HAMILTON depression scale score after stroke at different sites were compared. Results In the post-stroke depression group, the proportions of hypertension, diabetes mellitus, insomnia, aphasia and NIHSS score>15 points were 48.89%, 55.56%, 82.22%,77.78%, and 80.00%, which were higher than 16.36%, 20.00%, 43.64%, 40.00% and 43.64% of the post-stroke non-depression group, and the differences were statistically significant(P<0.05). Insomnia and NIHSS score >15 points were independent risk factors for post-stroke depression(P<0.05). The differences in number of lesions, lesion volume, anterior-posterior brain distribution, brain atrophy between the two groups were statistically significant(P<0.05). The HAMILTON depression scale scores in the frontal and temporal lobes were(24.21±4.26)and(23.25±3.32) points, which were significantly higher than(14.50±4.15) points in the basal ganglia and(14.26±3.35) points in the cerebellum, and the differences were statistically significant(P<0.05). There was no statistically significant difference between the frontal and temporal HAMILTON depression scale scores(P>0.05).Conclusion The occurrence of post-stroke depression caused by cerebrovascular disease is related to insomnia and neurological impairment. The imaging features of post-stroke depression are prominent, and the site of stroke(frontal and temporal lobes), multiple lesions and large size are closely associated with the occurrence of poststroke depression.