急性脑卒中患者的精神障碍及其相关因素分析

目的探讨急性脑卒中患者的心理健康状况及其相关因素，为临床更有效的治疗脑卒中提供依据。方法采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和SCL-90症状自评量表（SCL-90）对急性脑卒中患者和正常对照者各168例进行测评，并且在脑卒中的不同病变性质之间、病灶部位之间以及病灶大小之间进行神经心理学的对照研究。结果脑卒中组SAS焦虑状态总分、SDS总分以及精神情感症状、躯体化障碍、精神运动性障碍、抑郁的心理障碍的评分也均明显高于对照组（P〈0．01），SCL-90总分以及躯体化、抑郁、焦虑、紧张、强迫、睡眠障碍的评分也均明显高于对照组（P〈0．01）；在脑卒中组内左半球病变、皮层病变、多发病灶、大病灶和大脑前部受损者的神经心理学改变程度比右半球病变、皮层下病变、单发病灶、小病灶和大脑后部受损者重（P〈0.05）。结论急性脑卒中患者同时存在不同程度的焦虑抑郁症状，且有较多的心身症状；急性脑卒中患者有神经心理学改变，且神经心理学改变与病变性质、部位、数量和面积有关。

The relative factors of post-stroke mental disorder in early acute stroke

Objective To investigate the anxiety, depressions, mental health status of early acute stroke and relative factors. Methods The Self-Rating Anxiety Scale（SAS）, Depression Scale （SDS） and Symptom Checklist 90（SCL-90） were used to rate the patients in early acute stoke acute phase （n = 168） and control subjects （n = 168）. The neuro-phsychology research was preformed in the patients who had different type of stroke, location in brain and volume. Results The significant difference was found in SAS and SDS between the two groups（P〈0. 01 ）. There was a significant difference in total score of SCL-90, factor-core of somatization. epression, anxiety, nerveness, force and dyssomnia between the two groups （P〈0. 01）. The neurophsychology change in cases of left hemisphere stroke was more obvious compare with the cases of the right hemisphere stroke （P〈0. 05）. The neuro-phsychology changes was more obvious in cases of cortical lesions stroke than in the sub-cortical lesions （P〈0. 05）, and was more obvious in multiple lesions than in single lesions （P〈0. 05）. The neuro-phsychology change was more obvious in cases of big lesions than in small lesions （P〈0. 05）, and in front of brain than in post of brain （P〈0. 05）. Conclusions The anxiety, and depression are found to be high prevalent among stroke in acute stage. The patients with acute stage have more mental deficits. The neuro-phsychology change is related with the nature of lesions, the location of lesions, the number of locations and the area of lesions.