老年人脑卒中后抑郁84例临床分析

目的探讨老年人卒中后抑郁（PSD）的发生率、临床表现、相关因素和治疗情况。方法分析符合PSD诊断的84例老年患者的临床特点，并对其抗抑郁治疗前后SDS、HAMD评分进行比较。结果老年PSD的发生率为37．2％。其中以轻、中度抑鄙为主，占85．71％；老年人PSD的临床表现特点为情绪低落、易情绪失控、可伴焦虑、易疲劳、认知功能障碍、失眠或昼夜睡眠节律颠倒。老年人文化程度高、性格内向者和多次卒中的患者易发生卒中后抑鄙，在不同年龄组、不同性别和不同卒中类型中，抑郁情绪的发生率无明显差异。SSRI或SNRI类药物治疗1个月，SDS和HAMD评分有明显改善。结论老年人PSD发生率高，选择性血清素回收抑制剂（SSRI）或双重再回收抑制剂（SNRI）类药物抗抑郁治疗有效，在重视躯体康复的同时应积极治疗抑郁。

Clinical Analysis of 84 Old Patients with Post - stroke Depression

Objective To explore the incidence,clinic manifestation,relevant factors and therapy of poststroke depression(PSD) after old-age cerebral apoplexy were analysed(OACA).Methods 226 patients of OACA were evaluted according to the HAMD standard and 84 patients were selected as PSD and their clinic features were analysed.Results The PSD incidence after OACA was 37.2%,while mild and middle degree depression were primary(72/84).The clinic features of PSD after OACA were easy low emotion,emotion uncontrolled accompanying anxiety,easy tiredness,agrypnia or sleep rhythm reverse.Those olders who had high knowledge level,diffidence personality and many cerebral apoplexies had more possibility of PSD after OACA.The SDS and HAMD scores were improved significantly after 1 month treatment of SSRI or SNRI drugs.Conclusion The PSD incidence in the olders was high and SSRI or SNRI drugs had significant therapeutic effect on PSD.It is also important to actively treat depression condition in the course of physical rehabilitation.