脑卒中患者急性期抑郁发生情况及相关因素的探讨

目的探讨脑卒中患者急性期抑郁的发生情况及影响因素。方法采用Zung氏抑郁自评量表(SDS)、NIH卒中量表、ADL评定量表(BI)、社会支持评定量表(SRSS)及自设问卷评价了86例急性期的脑卒中患者,并分析了抑郁与年龄、性别、发病部位、发病性质、神经功能缺损程度、日常生活自理能力、脑卒中病史、合并症、医疗负担及社会支持情况等的相关性。结果41例(47.7%)出现抑郁症状,其中轻度29.1%,中度10.5%,重度8.1%。神经功能缺损程度为轻度、中度和重度的抑郁发生率分别为36.7%,47.6%和81.3%;日常生活自理能力为良、中和差的抑郁率分别为30.0%,47.6%和76.0%;基本无医疗负担、有些负担和负担很重的抑郁发生率分别为39.3%、42.9%和81.3%;以上各组之间的差异有显著性意义(P<0.05);与有无合并糖尿病呈正相关(r=0.43,P<0.05),与社会支持评定量表总分(r=-0.24)和主观支持得分(r=-0.22)呈负相关(P<0.05)。结论脑卒中急性期抑郁发病率高,患者神经功能缺损程度、日常生活自理能力、合并糖尿病、医疗负担、社会支持情况与抑郁相关。

Investigation of depressive symptoms and the related factors in patients with stroke at acute stage

Objective To investigate the incidence of depressive symptoms and the related factors in patients with stroke at acute stage.Methods In 2006,86 patients in the general hospitals of Beijing were assessed with self-rating Depression Scale(SDS),the NIH Stroke Scale(NIHSS),Barhel Index and Social Support Scales(SRSS)within first month of stroke onset.Results 41(47.7%)showed deppresive symptoms,and the percentage of mild,moderate and severe depression were 29.1%,10.5% and 8.1% respectively.The incidence of depression of patients with mild,moderate and severe neurological deficit were 36.7%,47.6% and 81.3% respectively.The incidence of depression of patients with good,middle and poor self-care ability of daily life were 36.7%,47.6% and 81.3% respectively.The incidence of depression of patients with no burden,some burden and heavy burden were 39.3%,42.9% and 81.3%.There were significant differences between the above groups(P<0.05).The SRSS score(r=-0.24)and subjective support score(r=-0.22)were negatively correlated with the depression degrees(P<0.05.)Conclusions The incidence of depression in stroke patients at acute stage were quite high.The rates were correlated with the degree of neurological deficit,self-care ability of daily life,whether combining diabetes,care burden and social support.