脑卒中后抑郁及其对神经功能康复的影响  

Post-stroke Depression and Rehabilitation of Neurological Function

作　　者：程丰[1] 邵国富[1] 包仕尧[1] 

机构地区：[1]苏州大学附属第二医院神经内科,215004

出　　处：《中国心理卫生杂志》2004年第8期533-536,共4页Chinese Mental Health Journal

摘　　要：目的 :观察脑卒中后抑郁 (Post-StrokeDepression ,PSD)的发生率和相关因素 ;探讨选择性 5-HT抑制剂对脑卒中后抑郁神经功能康复的影响。方法 :选取急性脑脑卒中患者 13 2例 (脑梗死 78例 ,脑出血 5 4例 ) ,分别在病程 2周、 1,3 ,6,12月时给每一位入组患者行PSD诊断、神经功能缺损评分、日常生活能力评分 (ActivityofDailyLivingScale ,ADL)、汉密尔顿抑郁量表 (HamiltonDepressionScale ,HAMD)评分 ;同时完成Zung’s抑郁自评量表 (Self-RatingDepressionScale ,SDS)和焦虑自评量表 (Self -RatingAnxi etyScale ,SAS)。结果 :①脑卒中患者中约 44 70 %出现抑郁症状 ;②脑卒中类型和性别与PSD发生率无相关性 (P >0 0 5 ) ;③PSD的发生率和严重程度与神经功能缺损和日常生活能力下降程度有关。④PSD与病变部位、病灶大小、病灶单侧性均无明显相关 (P >0 0 5 ) ;⑤氟西汀抗抑郁治疗能明显改善病程 3、 6个月时的神经功能缺损 ,病程 12月时不仅抑郁症状减轻 ,日常生活能力改善 ,神经功能缺损减轻尤为显著。结论 :脑卒中后抑郁是急性脑血管病患者常见的长期并发症 ,并可影响患者功能康复的速度和程度。抗抑郁剂治疗能在抑郁症状明显改善的同时 。Objective:To detect depression in stroke patients and observe its influence on rehabilitation of neurological function and the effect of fluxetine therapy Methods:132 acute stroke patients (78 with infarction, 54 with hemorrhage) were included in the study After inclusion, we did five times of assessments at the end of 2 weeks, 1 month, 3 months, 6 months and 1 year respectively using HAMD assessment to determine whether there had depression or not, as well as SSS (modified Edingburgh-Scandinavian Scoring Scale) for neurological function, ADL (activity of daily living), and self rate depression and anxiety (Zung's self rate depression scale and anxiety scale) Of those with depression, 25 received fluxetine 20mg/d, other 32 with only regular treatment of stroke as control Results:According to results of HAMD, 59 of the 132 had depression (44 7%) The rate of depression had no significant difference between male and female, between those with infarction and with hemorrhage Depression had negative influence on neurological function and activity of daily living Depression had no relation to location, size and unilateral or bilateral of the loci Fluxetine improved depression, neurological function and activity of daily living from 3 months after stroke; its influence on neurological impairment was most significant at 1 year after stroke Conclusion: Post stroke depression is common after cerebral infarction or hemorrhage, it has negative influence on rehabilitation of neurological function and activity of daily living Fluxetine improves both neurological impairments and activity of daily function, as the same time of its improvement of depression

关 键 词：脑卒中 抑郁 神经功能 PSD 神经功能缺损 神经病学 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.41[医药卫生—临床医学]