卒中后发生抑郁的相关因素探讨

 目的 探讨脑卒中后抑郁(post stroke depression, PSD)的相关因素。方法 选取符合条件的脑卒中患者265例, 根据是否有PSD分成对照组(175例)和PSD组(90例)。回顾性观察与分析所有患者的性别、年龄、教育程度(按年计算)、既往史(高血压、糖尿病、冠心病、卒中史、抑郁病史)、入院时斯堪的纳维亚卒中量表(scandinavian stroke scale , SSS)评分、日常生活活动能力 (activities of daily living, ADL)评分、入院时测定的血清同型半胱氨酸水平、卒中部位及侧别和病灶多少, 并对所得数据进行整理和统计学分析。结果 PSD组的教育年限为(4.4±4.7)年, 对照组为(5.7±4.7)年, 两组相比差异有统计学意义(P<0.05)。PSD组既往抑郁发生率 (15.6%)较对照组(5.1%)高, PSD组中额叶损伤占22.2%, 对照组为8.6%, 差异也具有统计学意义(P<0.05)。PSD组SSS评分、ADL评分、血清同型半胱氨酸水平分别为(23.7±5.8)分, (13.72±5.6)分, (24.67±6.24)μmol/L, 对照组分别为(19.5±5.1)分, (26.35±10.2)分, (14.58±5.21)μmol/L, 差异均具有统计学意义(P<0.05)。Logistic回归分析表明额叶损害、SSS评分和ADL评分这三项对PSD的影响最大。结论 教育年限、既往有抑郁史、SSS评分、ADL评分、血清同型半光氨酸水平及额叶损害等因素均和PSD相关。PSD是一个多因素共同影响导致的疾病。

Clinical evaluation of post-stroke depression-related factors

Objective To evaluate the factors related to post-stroke depression(PSD). Methods 265 patients were divided into two groups. Control group included 175 patients without depression while PSD group included 90 patients with depression after stroke. Gender, age, education, past history of hypertension, diabetes, coronary heart disease, stroke and depression, scores of Scandinavian Stroke Scale(SSS)and activities of daily living(ADL), serum level of homocysteine, lesion location were analyzed. Result Education in PSD group was(4.4±4.7)years and in control group was (5.7±4.7)years(P<0.05).Past depression incidence in PSD group was 15.6% and in control group was 5.1%(P<0.05).SSS score, ADL score and concentration of serum homocysteine in both groups were (23.7±5.8), (13.72±5.6), (24.67±6.24)μmol/L and (19.5±5.1), (26.35±10.2), (14.58±5.21) μmol/L, respectively. Differences were all significant(P<0.05).Frontal lobe lesion rate in PSD group was 22.2% and in control group was 8.6%, there was also a significant difference(P<0.05). Logistic regression analysis indicated that scores of SSS and ADL and frontal lobel lesion had most important influence on PSD. Conclusions Education, scores of SSS and ADL, concentration of serum homocysteine, past history of depression and frontal lobe lesion are correlated with PSD.PSD is a disease caused by a number of factors together.