社会因素及人格个性对脑梗死早期智能障碍的影响

目的探讨社会心理因素、行为人格特征、情感障碍及生活相关事件对脑梗死患者早期智能障碍的影响。方法178例脑梗死患者(男134例,女44例),按入院顺序分为智能障碍组(98例),非智能障碍组(80例);对照组87例,对其应用A型性格问卷、艾森克个性问卷、抑郁自评量表及生活事件量表进行心理学检查,对比分析其智能障碍的发生与患者的性格特点、个性特征、情感障碍及负性生活事件的关系。结果智能障碍有98例,其中轻度49例,中度23例,重度26例。智能障碍组、非智能障碍组、对照组3组A型行为比较差异具有极显著性意义χ21=6.76,χ22=20.16,P<0.001;EPQ评定结果,神经质偏高和精神不稳定患者,智能障碍组较其他两组多χ21=23.56,χ22=34.49,P<0.001;有智能障碍者其焦虑情感及抑郁情感的发生均较其他两组高,χ21=21.904,χ22=88.5337,P<0.001。经历过负性生活事件者,发生智能障碍者比例较高,χ21=8.248,χ22=114.409,P<0.001。结论A型行为是脑梗死的易感行为,对脑梗死后的智能障碍的产生有影响。精神质的个性和不稳定情绪是脑梗死患者的主要情绪特征,与脑梗死后智能障碍的发生有关。血管性痴呆患者的情感障碍较一般脑梗死患者更加严重,可能与肢体瘫痪有关。负性生活事件的刺激对脑梗死后智能障碍的发生影响也很大。

Influence of social factor on intellectual disorder in early stage of cerebral infarction

Aim To explore the effects of social psychic factors,behavior personality characteristics,mental disorder and life- related accidents on intellectual disorder in early stage of cerebral infarction.Methods 178 patients(134 males and 44 females) were divided according to admitting order into intellectual disorder group(n=98),nonintellectual disorder group(n=80);control group(n=87).Type A personality questionnaire,Exon personality questionnaire,self rating depressive scale(SDS) and life- related accident scale were used for psychological examination and the relationships between occurrence of intellectual disorder and character,personality,affective disorder and negative life- related accidents were compared.Results In 98 cases of intellectual disorder,mild were 49 patients,moderate 23 patients,severe 26 patients.There was a significant difference in comparison of type A behavior between 3 groups(χ 21=6.76,χ 22=20.16, P< 0.001 );EPQ result,incidences of nervosity and unstable mentality in intellectual disorder group were higher than other two groups(χ 21=21.904,χ 22=88.533 7, P< 0.001);Incidence of anxiety and depression in intellectual disorder group were higher than those in other two groups(χ 21=21.904,χ 22=88.533 7, P< 0.001);Incidence of intellectual disorder was higher in patients with negative life- related accidents(χ 21=8.248,χ 22=114.409, P< 0.001).Conclusion Type A behavior is the susceptible behavior and will influence intellectual disorder after cerebral infarction.Nervosity personality and unstable mood are the main mood characteristics in patients with cerebral infarction which are related to occureence of intellectual disorder.The affective disorder in patients with vascular dementia is more severe than common cerebral infarction patients that might be related to paralysis.Stimulation of negative life- related accident also influences occurrence of intellectual disorder after cerebral infarction.