以头晕为主诉的无症状性脑梗死患者焦虑状态的临床分析

目的:探讨以头晕为主诉的无症状性脑梗死(ACI)患者的情绪状态及临床体验并观察抗焦虑/抑郁治疗的疗效.方法:对98例ACI患者采用汉密尔顿焦虑抑郁量表进行筛查,并根据ICD-10的诊断标准做出诊断后,给予抗焦虑/抑郁药物治疗和支持性心理治疗,以治疗前后的汉密尔顿焦虑量表(HAMA)的减分率和临床症状缓解程度来评定疗效.结果:处于焦虑状态的ACI患者,医检证实均有脑血管系统的轻微病损,头晕史0.5～7年,有心悸、气短、眩晕发作、失眠等自诉躯体症状,67.55%伴有高血压;经帕罗西汀和支持性心理治疗,100%显效,临床症状缓解.结论:以头晕为主诉的ACI患者,若经改善脑血流循环治疗无效者,则应实施抗焦虑/抑郁药物治疗和支持性心理治疗,可望获得良好疗效.

Anxiety of Asymptomatic Cerebral Infarction Patients with Complaints of Dizziness

Objective:To explore the emotion and clinical features of asymptomatic cerebral infarction (ACI) patients with complaints of dizziness and to observe the efficacy of anti-anxiety and antidepressive treatment.Methods:HAMA and HAMD was administered to screen the patients with anxiety and depression and diagnosis was made based on ICD-10 criteria. Anti-anxiety and antidepressive therapy and supportive psychological therapy were used. The reduction rates of the score of HAMA were used to assess the efficacy.Results:The ACI patients had mild impairment of cerebralvascular system, history of 0.5-7 years, physical symptoms of palpitation, shortness of breathing, episode of dizziness and insomnia, and 67.55% of them was accompanied with hypertension. After paroxetine and supportive psychological therapy, all these patients showed clinical improvement.Conclusion:The ACI patients with complaints of dizziness, if no response to the therapy of improving cerebral blood flowing, will reach good efficacy with anti-anxiety/antidepressive therapy and supportive psychological therapy.