脑卒中后抑郁患者CT表现及其临床特征的相关研究

目的探讨脑卒中后抑郁患者的CT表现和临床特征及其相关因素。方法选择98例CT确诊脑梗死的患者,进行颅脑CT扫描确定脑部异常病变,根据抑郁自评量表(SDS)、汉密顿抑郁量表(HAMD)分值分为有无抑郁症状两组:卒中后抑郁组(PSD组,n=42)和对照组(n=56)。结果抑郁的发生率为42.8%。两组患者的年龄、性别构成、受教育程度、病程等差异无统计学意义(P>0.05)。两组患者颅脑CT比较,结果显示PSD组损害更易发生于左侧半球、皮质、额叶和小脑。PSD组内抑郁量表分值与左侧半球、双侧皮质损害容积成正相关(P<0.05)。结论脑卒中后抑郁发生率较高,CT表现和临床特征有一定特点,额叶、皮质的损害可能是PSD发生的生物学基础。

CT findings and clinical features of post-stoke depression

Objective: To explore the CT findings and clinical feature and their relationship of post-stoke depression(PSD) patients.Methods: Ninety-eight patients with their first episode of stroke demonstrated by cerebral CT scan were tested of SDS and HAMD.According to their depression,all subjects were divided into two groups: PSD group(n=42) and control group(n=56).CT findings and clinical characteristics were compared between the two groups and the relationship between pathologic sites and occurrences of depression.Results:The frequency of depression was 42.8%.The depression frequency was not significantly related to patients' age,sex,education and course of disease(P>0.05).Cerebral CT showed that brain damages in left hemisphere,cortical,prefrontal lobe and cerebellum of the brain were more in PSD group than in control group(P<0.05).The degree of depression was correlated to the lesion volume of the left hemisphere,bilateral cortical in PSD group(P<0.05).Conclusion:The prevalence rate of depression is high in the post-stroke patients.Post-stroke depression has specific clinical characteristic and CT image finding,and prefrontal lobe and cortical structures damage may be one of the factors resulting in post-stoke depression.