缺血性脑卒中患者抑郁症状与发病部位的Logistic回归分析

目的：研究首发缺血性脑卒中偏瘫患者脑梗死部位对远期抑郁症状的预测价值，为早期干预提供依据。方法：采用临床流行病学调查方法，对103例为单侧病灶的首发缺血性脑卒中偏瘫患者进行远期（发病后20～44个月）抑郁症状与发病部位关系的现状调查，并用Logistic回归分析法进行分析。结果：103例入选病例中存在远期抑郁症状患者52例，抑郁症状发生率50．49％，其中左侧病灶24例，右侧病灶28例，差异无统计学意义（P〉0．05）。经Logistic回归分析，病灶与抑郁症状发生的相关性部位有额叶和颞叶脑梗死灶。结论：额叶和颞叶脑梗死灶是缺血性脑卒中偏瘫患者远期抑郁症状发生的独立危险因素，且颞叶梗死较额叶梗死患者抑郁症状重。

Multinomial Logistic Regression Analysis on Depression and Localization of Ischemic Stroke

Aim：To examine the predictive value of the localization of ischemic stroke （IS） during the period of sequela after stroke as a risk factor for long-term （20-24 months after stroke） depressive symptoms （DS）. Methods：Taken the ascertainment methods of epidemiology, the relationship of long-term（20-44 months after stroke） DS and localization in 103 patients with unilateral and first-episode ischemic stroke was estimated. Logistic regression analysis was also used. Results：Among 103 patients, 52 patients with long-term DS existed, the incidence rate was 50.49%. About the localization of IS,24 patients in the left,28 in the right,there was no statistical significance（P〉0.05）. The depressive symptoms were related to the localization of IS,especially in frontal lobe and temporal lobe, and had statistical significance（P〈0.05）, regression coefficients were 1.053 and 1.348 respectivly, OR were 2.865 and 3.851 respectivly.Among DS patients with localization in frontal lobe, slight DS were in 71.4%, middle in 19.0%, severe in 9.5%. Patients with localization in temporal lobe, slight DS were in 28.6%, middle in 35.7%, severe in 35.7%, and were more severe than the patients with localization in frontal lobe in the long-term depressive symptoms. Conclusion：The long-term depressive symptoms of patients with IS were related to localization, infarcted focus in frontal lobe and temporal lobe, were independent risk factors of the long-term depressive symptoms of patients with IS, and the depressive symptoms in temporal lobe were more severe than that in frontal lobe.