卒中后患者生物学及社会经济因素与抑郁症的相关性研究

目的通过对卒中后患者在年龄、性别、病程、卒中类型、基础疾病、血压、生化指标、神经心理学特点、经济支持等方面与卒中后抑郁发生的相关性研究,进一步发现相关度较高的一些因素,对今后的卒中后抑郁的防治提供依据。方法选取上海养志康复医院自2012年5月至2013年10月住院治疗的卒中后患者,在排除严重言语障碍及认知功能障碍后,根据DSM-Ⅳ的抑郁症诊断标准及MADRS评分,将入组患者分为病例组与对照组。所有患者均接受生化检查及访谈评估。分析比较病例组与对照组在上述各项指标方面的差异及相关性。结果回顾两组患者,在卒中次数(OR=2.862)、TIA发作(OR=2.596)、高血压(OR=2.528)、急性起病(OR=4.678)等方面具有明显的相关性,简易认知功能检查及自理能力、社会活动功能及物体命名能力方面差异有统计学意义(P<0.05)。结论卒中后抑郁的发生更多地取决于血管性疾病,尤其是高血压的治疗与控制,同时既往卒中发生及TIA发作对于卒中后抑郁的发生同样不利,认知能力及社会功能的完整性对于卒中后抑郁的发生具有积极意义。

The correlation between biology,socio-economic factors and the post-stroke depression occurrence

Objective To explore the correlation between biology, socio-economic risk factors and the PSD occurrence from comparing the PSD patients and the non-PSD patients. Provide the prevention and treatment of post-stroke depression future. Methods A total of 187 patients with stroke were divided into two groups PSD or non-PSD by DSM-Ⅳ and MADRS. All the patients completed the interview, biochemical tests and neuropsychological tests. Results Reviewed the two groups, we found significant correlation in the number of stroke（OR=2.862）, TIA（OR=2.596）, hypertension（OR=2.528）, acute onset（OR=4.678）. There was significant difference in MMSE, FAQ, BNT between two groups（P＆lt;0.05）. Conclusions The occurrence of depression after stroke depends more vascular disease, particular for the treatment and control of hypertension. Meanwhile, previous episodes of stroke and TIA for post-stroke depression occurs equally unfavorable. Also the integrity of the cognitive and social functions for the occurrence of post-stroke depression has a positive meaning.