脑卒中后抑郁情绪表现特点及相关因素研究

目的探讨卒中后伴发抑郁（PSD）的特点及其相关因素。方法对240例卒中后患者进行汉密尔顿抑郁量表（hamilton depression scale，HAMD）评分，并同时评定神经功能缺损积分。结果卒中后抑郁的发生率为49．2％，其中轻度抑郁占27．1％、中度抑郁占16．7％及重度抑郁占5．4％。其抑郁情绪主要表现为焦虑／躯体化、阻滞、认识障碍、绝望感和睡眠障碍；病灶位于皮层和皮层下的病例组HAMD总分、阻滞、绝望感因子分显著高于病灶位于小脑和脑干的病例组；抑郁程度与年龄、性别、受教育程度无相关关系，而与神经功能缺损程度和发病部位有关。结论卒中后患者抑郁发生率较高，不同部位的卒中有其抑郁特点，病灶位于大脑皮层和皮层下的患者更容易出现PSD。其抑郁程度与患者神经功能缺损程度密切相关。

Features of Post-stroke depression and the relative factors

Objective] To investigate the features of Post-Stroke Depression(PSD) and the relative factors. Methods] Use Hamilton Depression Scale(HAMD) to measure the level of depression of 240 post-stroke patients. The neurological deficits scores were assessed in the patients. Results] 49.2% were identified to have PSD, among whom 27.1% were of minor degree,16.7% were moderate, and 5.4% were severe. The main manifestations of depression were anxiety/body, retardation, dysfunction of congnition, hopelessness and insomnia. Scores of HAMD, retardation and hopelessness factors were significantly higher in the patients whose focus were in cortex and hypophloeodal than those in cerebel and brain stem?The level of depression positively correlated with the degree of the neurological deficits, and it had no relation with age, sex and education. Conclusions] The incidence of depression was high in post-stroke patients. Patients whose focus were different had different characteristics of depression. The patients whose focus were in cortex and hypophloeodal are more likely to get depression. The degrees are closely related to the degree of the neurological deficits.