社会支持在老年急性脑梗死与梗死后抑郁之间的调节效应分析

The moderating effect of social support on the relationship between acute cerebral infarction and depression after infarction in the elderly

目的 分析社会支持在老年急性脑梗死(ACI)与梗死后抑郁之间的调节效应。方法 回顾性分析2021年8月至2022年7月浙江大学医学院第二附属医院收治的115例老年ACI患者的临床资料。采用美国国立卫生研究所卒中量表(NIHSS)、抑郁自评量表(SDS)、社会支持量表(SSRS)评估老年ACI患者的神经功能缺损程度、抑郁严重程度、社会支持水平。采用Pearson相关分析SSRS评分、NIHSS评分与SDS评分的相关性。采用分层回归分析社会支持在老年ACI与梗死后抑郁程度之间的调节效应。结果 患者的NIHSS评分为(9.08±2.11)分,SDS评分为(55.90±9.36)分,SSRS评分为(38.10±5.64)分。不同性别、年龄、婚姻状况、梗死部位、饮酒史、高血压病史、高血脂史、受教育程度患者的SDS评分比较,差异均无统计学意义(均P>0.05)。Pearson相关分析显示,老年ACI患者的SDS评分与NIHSS评分呈正相关(r=0.424,P=0.016),与SSRS评分呈负相关(r=-0.469,P=0.013)。分层回归分析结果显示,社会支持与老年ACI的交互项存在调节效应(β=-0.192,P<0.001)。结论 社会支持在老年ACI患者与梗死后并发抑郁间存在调节效应,高社会支持可缓解老年ACI患者的抑郁情况。

Objective To explore the regulatory effect of social support on the relationship between acute cerebral infarction(ACI) in the elderly and depression after infarction.Methods Retrospective analysis of the clinical data of 115 elderly patients with ACI were admitted to the Second Affiliated Hospital of Zhejiang University Medical College from August 2021 to July 2022.National Institutes of Health Stroke Scale(NIHSS),Self-Rating Depression Scale(SDS) and Social Support Rating Scale(SSRS) were used to evaluate severity of ACI,severity of depression and social support level in elderly patients with ACI.Pearson method was used to analyze the correlation among SSRS,NIHSS and SDS.Hierarchical regression analysis was used to explore the moderating effect of social support on the relationship between ACI and depression after cerebral infarction in the elderly.Results The average NIHSS score of 115 elderly patients with ACI was(9.08±2.11),the average SDS score was(55.90±9.36),and the average SSRS score was(38.10±5.64).There were no statistically significant differences in SDS scores of patients with different gender,age,marital status,infarction site,drinking history,hypertension history,hyperlipidemia history and education level(P > 0.05).Pearson correlation analysis showed that the SDS score of elderly ACI patients was positively correlated with the NIHSS score(r=0.424,P=0.016),and negatively correlated with the SSRS score(r=-0.469,P=0.013).Hierarchical regression analysis showed that there was a moderating effect between social support and ACI in the elderly(β=-0.192,P < 0.001).Conclusions Social support has a regulatory effect between elderly ACI patients and post-infarction depression,and high social support can alleviate the depression of elderly ACI patients.