高血压脑出血卒中后抑郁风险因素相关性研究

目的 探讨高血压脑出血患者卒中后抑郁相关影响因素。方法 前瞻性录入65例急性高血压脑出血患者临床和计算机断层扫描（computer tomography，CT）影像资料，评估患者发病14d和3个月卒中后抑郁发生情况及生存质量状况，对临床资料和CT影像特征与卒中后抑郁的关系进行单因素和多因素分析。结果 65例患者中有57例完成14d随访，53例完成3个月随访。脑出血发病14d和3个月卒中后抑郁的发生率分别为35.1%和38.9％。单因素分析显示入院后首次美国国立卫生研究院卒中量表评分（thenational institutes of health stroke scale, NIHSS）与高血压脑出血发病后14d卒中后抑郁相关（P =0.027）。性别、出血部位和出血量与脑出血发病后3个月卒中后抑郁相关：与非抑郁组比较，抑郁组患者男性比例较低（P =0.038），基底节出血比例较高（P =0.031），平均出血量大（P =0.046）。多因素分析显示出血量是高血压脑出血患者发病3个月卒中后抑郁的风险预测因素（P =0.049）。结论 NIHSS评分和CT影像特征可作为高血压脑出血卒中后抑郁的评价指标，将CT影像与神经功能缺损程度评分有机结合可为脑出血综合性治疗策略的建立提供客观依据。

Correlation Associated to Poststroke Depression in Patients with Hypertensive Intracerebral Hemorrhage

Objective To investigate the determinants of poststroke depression （PSD） in patients with hypertensive intracerebral hemorrhage （ICH）. Methods Sixty-five patients suffered from acute hypertensive intracerebral hemorrhage with related clinical materials such as gender, age, neurological deficit severity scale （NIHSS） as well as the brain computer tomography（CT） findings were screened prospectively. All patients were evaluated at day 14 and 3 months after ICH onset for poststroke depression and quality of life with the Hamilton Depression Rating Scale （HDRS） and the modified Rankin Scale （mRS）, respectively. Univariate analysis and multivariate stepwise logistic regression were used to analyze the relationships between clinical materials and CT features and PSD. Results Fifty-seven of sixty-five patients completed the assessment at day 14 and 53 patients completed the follow-up at 3 months. About thirty-five percent and thirty-eight percent respectively reported the HDRS score greater than 7 at day 14 and 3 months after 1CH onset, indicating at least a minor degree of poststroke depression. Univariate analysis showed that there was a relationship between first NIHSS score and PSD at day 14 after ICH onset （P=0.027）. Gender, hemorrhage location and ICH volume were correlated with PSD at 3 months after JCH onset. Compared with the non-PSD, male patients in the PSD group were less （P=0.038） and the proportion of hemorrhage located in basal ganglia was greater （P=0.031） as well as the average of ICH volume was larger （P=0.046）. Multivariate analysis demonstrated that ICH volume was a predictor of PSD at 3 months after ICH onset （P=0.049）. Conclusion N1HSS score and CT features may be used to assess poststroke depression in patients with intracrebral hemorrhage, CT characteristics together with neurological deficitseverity scale can provide objective evidence for comprehensive treatment of hypertensive intracerebral hemorrhage.