脑卒中后抑郁状态患者病灶部位与预后的相关性

背景脑卒中后抑郁状态的发生率较高,而对本病缺乏足够的认识.目的探讨脑卒中后抑郁状态的病灶部位与预后关系.设计以诊断为依据的回顾性研究.地点和对象选择1995-12/1999-12在青岛市人民医院及解放军第四○一医院住院的脑卒中患者489例,符合标准的151例(病例组),男89例,女62例,年龄60～78岁,平均(67.27±7.05)岁.脑梗死109例,脑出血42例.同期选择年龄相当的健康人120例为正常对照组.方法回顾性分析脑卒中患者151例,采用汉密尔顿抑郁量表(Hamiltondepressionrating scale,HAMD)进行评定.主要观察指标大脑半球前、后、左、右各部位病灶数及各病灶部位患者HAMD得分.结果抑郁发生率为30.88%,轻、中、重度分别占25.17%,71.52%,3.31%.病例组HAMD总分21.58±4.59,正常组4.59±1.67,两组比较有显著性差异(t=38.58,P＜0.01).临床表现以中度抑郁状态为多见.病灶在左侧半球(19.35±4.39)和前半球(19.57±5.43)HAMD评分显著高于右侧半球(16.55±5.37)和后半球(17.534.85),差异有显著性意义(t=3.86,2.55,P＜0.01～0.05),更易发生抑郁状态.结论脑卒中后抑郁多发于左侧半球及前半球,提高对此症的认识,对于脑卒中患者的康复有很大帮助.

Correlation betweenfocus and prognosis in patients with post-stroke depression states

BACKGROUND: The incidence of post-stroke depression is very high.However, there is not much knowledge about this disease.OBJECTIVE: To explore the correlation between focus of depression and its prognosis of post stroke.DESIGN: Retrospective analysis on the basis of diagnosis.SETTINGS and PARTICHANTS: Four hundred and eighty-nine patients of cerebral stroke diagnosed between December 1995 and December 1999 in Qingdao Municipal People' s Hospital, the 401 Hosptial of Chinese PLA were chosen. One hundred and fifty-one patients who meet the standard were selected as case group, including 89 males and 62 females, aged from 60 to 78 years old, average age was 67.27 ± 7.05 years old. There were 109 patients with cerebral infarction, 42 patients with cerebral hemorrhage. One hundred and twenty normal people with same age were selected as normal control group.METHODS: Hamilton depression rating scale(HAMD) was used in the retrospective analysis of 151 patients with cerebral stroke.MAIN OUTCOME MEASURES: Number of focuses in the front, back, left and right areas of cerebral hemisphere and the HAMD scores of patients with different focused.RESULTS: Incidence of depression was 30. 88%, mild, moderate and severe level accounted for 25.17%, 71.52% and 3.31% respectively. The total HAMD score of patient group was 21.58 ±4.59, in normal group was 4. 59 ± 1.67. There was significant difference between these two groups( t =38.58, P ＜ 0.01). Moderate depression state was the commonly seen clinical manifestation. The HAMD score of focus in left hemisphere(19.35 ±4. 39) and in front hemisphere (19.57 ± 5.43 ) was much higher than that in right hemisphere(16.55 ±5.37) and back hemisphere(17.53 ±4. 85),there was significant difference( t = 3.86, 2.55, P ＜ 0.01 -0.05) . The focuses there more likely led to depression.CONCLUSION: Most post-stroke depression happen in the left hemisphere or front hemisphere. It will stimulate the rehabilitation of this disease with the knowledge of it increasing.