脑卒中后抑郁障碍的临床分析

目的分析脑卒中后抑郁障碍(post-stroke depression disorder,PSDD)的发病相关因素。方法对入选的697例脑卒中患者的性别、年龄、脑卒中类型、脑卒中病灶部位、美国国立卫生研究院脑卒中量表(National Institutesof Health Stroke Scale,NIHSS)神经功能缺损程度评分、Barthel指数(BI)、汉密尔顿抑郁量表评分(HamiltonRating Scale for Depression,HAMD)进行记录,并对不同分类中PSDD发生率进行比较。结果脑出血PSDD发生率明显高于脑梗死PSDD发生率(26.6%vs 16.3%,x~2=6.48,P=0.01)。PSDD患者入院时NIHSS评分明显高于无PSDD患者(6.00±4.60)分vs(4.52±3.74)分],BI评分明显低于无PSDD患者(57.40±26.54)分vs(68.1 6±25.76)分],差异有统计学意义(P<0.01)。PSDD患者入院时NIHSS评分HAMD呈正相关(r=0.21,P<0.01),入院时BI评分与HAMD呈负相关(r=-0.18,P<0.01)。logistic回归分析显示,入院时BI评分是抑郁的保护因素(标准偏回归系数=-0.02,OR=0.98,95%CI:0.98～0.99,P<0.01)。结论 PSDD与脑卒中类型、入院时NIHSS评分及BI评分有关。

Clinical analysis of post-stroke depression disorder

Objective To analyze the relative pathiogenetic factors for post-stroke depression disorder (PSDD).Methods Six hundred and ninety-seven cerebral stroke patients were enrolled in this study.Their gender,age,cerebral stroke type and foci,NIHSS score,Barthel index(BI) and Hamilton rating scale score were recorded.The incidence of different PSDD types was compared.Results The incidence of cerebral hemorrhage was significantly higher in PSDD patients than in cerebral infarction patients at admission(26.6%vs 16.3%,χ~2 = 6.48,P = 0.01).The NIHSS score was significantly higher while the BI was significantly lower in PSDD patients than in nonPSDD patients at admission(6.00±4.60 vs 4.52±3.74,57.40±26.50 vs 68.16±25.76,P< 0.01).The NIHSS score was positively related while the BI was negatively related with the occurrence of PSDD.Logistic regression analysis showed that the BI was a protective factor for PSDD(OR = 0.98,95%CI:0.98—0.99,P<0.01).Conclusion PSDD is related with the stroke type,NIHSS score and BI.