脑出血急性期抑郁症发生的相关危险因素及防治对策

目的研究脑出血急性期患者抑郁症的相关危险因素及防治对策。方法 148例患者用汉密尔顿抑郁量表,美国国立卫生研究院卒中量表,蒙特利尔认知量表,及改良Rankin量表分别评估;用经颅多普勒,颅脑CT检查;并对抑郁症患者采用心理、药物5-羟色胺再摄取抑制剂干预治疗后2周、1、2和6个月用上述量表评估其疗效。结果 (1)本组并发抑郁症患者101例(69.7%),女性高于男性(P<0.01)。(2)抑郁症患者MoCA评分显著低于非抑郁症患者(P<0.01),NIHSS评分、mRS显著高于非抑郁症患者(P<0.01)。(3)脑出血在额叶、颞叶、基底节时抑郁症发生率较高,左侧半球高于右侧半球。(4)抑郁症患者的大脑中、前动脉血流速度低于非抑郁症患者,阻力指数高于非抑郁症患者。结论脑出血后抑郁症的发生与NIHSS、MoCA评分及性别、出血部位有显著的相关性,早期治疗能促进患者的神经功能恢复。

Melancholia incidence in the acute period of cerebral haemorrhagia and its correlated factors

Objective We evaluate the melancholia incidence in the acute period of cerebral haemorrhagia and its correlated factors and control measures.Results 148 cerebral haemorrhagic patients were assessed respectively by Hamilton Depression Scale（HAMD）, the NIH Stroke Scale（NIHSS）. Montreal cognitive assessment （MoCA）and the modified Rankin Scales（mRS）. The patients were detected with TCD and CT. And patients were give psychotherapy and 5-HT reuptake inhibitor drugs,and were evaluated with above measure is to assess its success in two weeks after the treatment and 1, 2 and 6 months.Results ①The melanchaolia incidence in the acute period was 101（69.7%） femal is higher than male.②The grades assessed by MoCA were significantly lower in the Melancholia group than those with no Melancholia （P0.01）while the grades assessed by NIHSS、mRS were significantly greater. ③Haemorrhagic in frontal, porietal lobe, basal ganglia have higher melancholia incidence,and left cerebral hemispheres was higher than the right.④The average blood velocity of MCA and ACA in the melanchaolia patients was significantly slower than that of non-melanchaolia patients while resistance index was significantly higher. Conclusion Melanchaolia incidence in the acute period of cerebral haemorrhagia has positive correlationship with sex, NIHSS greades,MoCA greades,haemorrhagic sites,haemorrhagic blood quantity indicates. Early treatment can promote the function of nerves again.