脑卒中后抑郁障碍患者再发脑卒中的相关影响因素分析

Analysis of related factors of recurrent stroke in patients with post-stroke depression

目的探讨脑卒中后抑郁障碍患者再发脑卒中的相关影响因素。方法回顾性分析68例缺血性脑卒中患者的一般临床资料、脑卒中治疗情况、抑郁发生情况及其治疗干预情况和出院后的随访情况等临床资料,对缺血性脑卒中后抑郁障碍患者再发脑卒中的相关影响因素进行观察,对导致脑卒中复发的关键危险因素进行确定。结果68例患者中,发生脑卒中后抑郁障碍50例(73.53%),未发生18例(26.47%);脑卒中后抑郁障碍患者脑卒中复发率为22.00%(11/50),高于非脑卒中后抑郁障碍患者的11.11%(2/18),差异有统计学意义(P<0.05)。脑卒中后抑郁障碍患者的年龄(68.34±11.45)岁、女性占比42.00%、心脏病史占比36.00%、抗抑郁治疗占比30.00%、入院首次美国国立卫生研究院卒中量表(NIHSS)评分(4.85±2.34)分均高于非脑卒中后抑郁障碍患者的(61.23±10.34)岁、11.11%、11.11%、5.56%、(3.11±0.34)分,差异有统计学意义(P<0.05)。脑卒中后抑郁障碍患者与非脑卒中后抑郁障碍患者的高血压病占比、糖尿病占比、高脂血症占比、吸烟占比、过量饮酒占比、脑卒中史占比、入院收缩压、入院舒张压、脑卒中后教育占比比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,年龄、心脏病史、入院首次NIHSS评分为脑卒中后抑郁障碍患者发生脑卒中复发的独立危险因素(P<0.05)。结论脑卒中患者发生抑郁障碍会使其脑卒中复发的风险大幅度增加,患者年龄、心脏病史和入院首次NIHSS评分为脑卒中后抑郁障碍患者发生脑卒中复发的独立危险因素,对这些独立危险因素进行纠正和控制可以有效预防和降低脑卒中复发。

Objective To discuss the related factors of recurrent stroke in patients with post-stroke depression.Methods The general clinical data,stroke treatment,depression occurrence,treatment intervention,and follow-up after discharge of 68 patients with ischemic stroke were retrospectively analyzed.The related influencing factors of recurrent stroke in patients with post-stroke depression were observed,and the key risk factors leading to recurrent stroke were identified.Results Among the 68 patients,50 cases(73.53%)had post-stroke depression,while 18 cases(26.47%)did not.The recurrence rate of stroke in patients with poststroke depression was 22.00%(11/50),which was higher than that of 11.11%(2/18)in patients without poststroke depression,and the difference was statistically significant(P<0.05).The age of patients with post-stroke depression was(68.34±11.45)years old,the proportion of women was 42.00%,the proportion of cardiac history was 36.00%,the proportion of antidepressant treatment was 30.00%,and the NIHSS score at admission was(4.85±2.34)points,which were higher than those of(61.23±10.34)years old,11.11%,11.11%,5.56%,and(3.11±0.34)points of patients without post-stroke depression,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the proportion of hypertension,diabetes mellitus,hyperlipidemia,smoking,excessive drinking and history of stroke,admission systolic blood pressure,admission diastolic blood pressure and post-stroke education between patients with and without post-stroke depression(P>0.05).Multivariate Logistic regression analysis showed that age,cardiac history and NIHSS score at admission were independent risk factors for recurrent stroke in patients with post-stroke depression(P<0.05).Conclusion The occurrence of depression in stroke patients will significantly increase the risk of stroke recurrence.The patient's age,cardiac history and the NIHSS score at admission are independent risk factors for stroke recurrence in patients with post-stroke depression.Correcting and controlling these independent risk factors can effectively prevent and reduce stroke recurrence.