脑梗死后抑郁的危险因素及与体质相关性分析

目的:探讨脑梗死后抑郁的危险因素及与体质的相关性,为基于中医体质干预脑梗死后抑郁提供参考。方法:纳入脑梗死后抑郁患者和脑梗死后无抑郁患者各126例,所有患者进行中医体质辨识。分析脑梗后抑郁的中医体质分布以及美国国立卫生研究院卒中量表(NIHSS)、日常生活能力Barthel指数评定量表(BI)、病程、梗死部位等危险因素。结果:单因素分析显示,文化程度、睡眠障碍、吸烟、病程、梗死部位、NIHSS评分、BI评分、主观支持、支持利用度、气郁质、气虚质与脑梗死后抑郁的发生有关。Logistic回归分析显示病程长、NHISS评分高、额叶梗死是脑梗死后抑郁的危险因素;BI和主观支持是抑郁的保护因素;气郁质、气虚质是抑郁的重要致病体质。结论:气郁质、气虚质是脑梗死后抑郁的重要致病体质,病程长、NHISS评分高、额叶梗死是脑梗死后抑郁的危险因素,可以基于体质防治抑郁。

Analysis of Risk Factors of Post-cerebral Infarction Depression and Its Correlation with Body Constitution

Objective:To explore the risk factors of post-cerebral infarction depression and its correlation with body constitution,and to provide a reference for the intervention of post-cerebral infarction depression based on traditional Chinese medicine(TCM) constitution. Methods:There were 126 patients with post-cerebral infarction depression and 126 patients with post-cerebral infarction but no depression. TCM body constitution types were determined in all the included patients. The distribution of TCM constitution of patients with post-cerebral infarction depression,and the indexes like National Institutes of Health Stroke Scale(NIHSS) score and Barthel Index of Daily Living(BI),course of disease,infarction and other risk factors were all analyzed. Results:Univariate analysis showed that cultural degree,sleep disorder,smoking,course of disease,infarction,NIHSS score,BI score,subjective support,support availability,qi depression and qi deficiency were related to the occurrence of cerebral infarction with depression. Logistic regression analysis showed that long course of disease,NHISS score,frontal lobe infarction were the risk factors of post-cerebral infarction,BI score and subjective support were the protective factors of depression,and qi depression and qi deficiency were the major pathogenic factors for depression. Conclusion:For post-cerebral infarction,qi stagnation and qi deficiency body constitutions are the major body constitutions which can lead to depression. Long course of disease,NHISS score and frontal lobe infarction are risk factors for post-cerebral infarction depression. Preventing post-cerebral depression could be based on body constitution.