老年脑卒中后抑郁患者的影响因素研究

目的:研究缺血性脑卒中老年患者卒中后抑郁(PSD)与社交、失眠以及神经功能缺损程度的相关性。方法:253例老年缺血性脑卒中患者根据是否抑郁分为PSD组119例和非PSD组134例,采用美国国立卫生研究院卒中量表(NIHSS)评定神经功能缺损程度,Barthel指数(BI)评价日常生活活动能力,多因素非条件Logistic回归分析PSD与社交、失眠及神经缺损程度的相关性。结果:PSD组和非PSD组的失眠(P=0.003)、独居(P=0.034)、不良生活事件(P=0.022)及NIHSS评分(P=0.004)和BI评分(P=0.002)差异有统计学意义;多因素非条件Logistic回归分析表明失眠(P=0.015)、NIHSS评分(P=0.001)、BI评分(P=0.004)与PSD形成紧密相关;重度抑郁PSD患者与中、轻度抑郁患者相比具有较高失眠率(t=2.18,P=0.035;t=3.46,P=0.024)、较高NIHSS评分(t=4.29,P=0.003;t=4.52,P=0.006)及较低BI评分(t=4.03,P=0.005;t=2.34,P=0.001)。结论:失眠、神经功能损伤程度及日常活动活动能力与老年脑卒中患者PSD的形成显著相关。

Influencing Factors of Post-stroke Depression in Chinese Elderly Population

Objective:To study the association among post-stroke depression (PSD),social,insomnia,neurologic defect in patients with ischemic stroke.Methods:Two hundred and fifty-six elderly patients with ischemic stroke were divided into the PSD group (n=119) and PSD group (n=134) according to whether depression.Degree of nerve function defect was evaluated by National Institutes of Health stroke scale (NIHSS),and daily life activities ability was evaluated by Barthel index (BI).Correlation of PSD with social,insomnia and nerve defect were analyzed by Logistic regression analysis.Results:Difference between PSD group and non-psd group (P=0.003),solitary (P=0.034),adverse life events (P=0.022) and NIHSS scores (P=0.004) and BI scores (P=0.002) were statistically significant.Multifactor non-conditional Logistic regression analysis showed that insomnia (P=0.015),NIHSS scores (P=0.001),BI scores (P=0.004) were closely related to PSD formation.Major depression,compared to patients with mild depression in patients with PSD and had a higher rate of insomnia (t=2.18,P=0.035;t=3.46,P=0.024),higher NIHSS score (t=4.29,P=0.003;t=4.52,P=0.006) and lower BI score (t=4.03,P=0.005;t=2.34,P=0.001).Conclusion:Insomnia,neurological impairment and daily activity activity were significantly correlated with PSD in elderly patients.