卒中后抑郁及其治疗对神经功能康复的影响  

Influence of Post-stroke Depression and its Treatment on Rehabilitation of Neurological Functions

作　　者：邵国富[1] 程丰[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：《神经疾病与精神卫生》2005年第1期9-13,共5页Journal of Neuroscience and Mental Health

摘　　要：目的　观察卒中后抑郁(PSD)的发生率和相关因素;探讨百优解抗抑郁治疗对卒中后抑郁患者神经功能康复的影响。方法　选取急性脑卒中患者132例(脑梗死78例,脑出血54 例),分别在病程2周、1月、3月、6月、12月行PSD诊断、神经功能缺损评分(SSS)、日常生活能力评分(ADL)、汉密尔顿抑郁量表( HAMD)评分,同时完成Zung’s 抑郁自评量表( SDS)和焦虑自评量表( SAS)。结果　(1)脑卒中患者中约44.70%出现抑郁症状;(2)卒中类型和性别与PSD发生率无相关性(P>0.05);(3)PSD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。(4)PSD与病变部位、病灶大小、病灶半球利性均无相关性(P >0.05);(5)百优解能明显改善病程3、6 月时神经功能缺损,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　卒中后抑郁是急性脑血管病患者常见的长期并发症,并可影响患者神经功能康复的速度和程度。抗抑郁治疗能在抑郁症状明显改善的同时,促进患者神经功能和日常生活能力的恢复。Objective To observe morbidities and relative factors of post-stroke depression (PSD), and study the influence of anti-depression treatment with PROZAC (Fluoxetine hydrochloride) on rehabilitation of neurologic impairment in patients with PSD. Methods 132 cases with acute cerebrovascular disease, of which 78 patients with cerebral infarction and 54 cases with cerebral hemorrhage, were studied. All patients were estimated by SSS、ADL and HAMD scales in different course of disease. Meanwhile they were asked to finish SDS and SAS scales. Results 1) The morbidity of PSD was 44.70%; 2) There was no difference in PSD morbidities between cerebral infarction and cerebral hemorrhage (P>0.05), as well as no gender difference. 3) The morbidity and severity of PSD were related to the degrees of neurological impairment and daily living ability decline. 4) PSD was not correlated with stroke location, size and hemisphere preference (P>0.05). 5) PROZAC remarkably ameliorated neurological impairment at 3 and 6 months, furthermore relieved depression symptom and defect of ability in daily living and more neurological impairment at 12 months. Conclusions PSD is a frequent and long-term complication in acute cerebrovascular disease, which influences speed and degree of rehabilitation of neurological impairment in stroke patients. Anti-Depressive therapy could ameliorate the symptom of depression and improve the ability of daily living and neurologic function notably.

关 键 词：脑卒中 抑郁 神经功能 神经康复 PSD 脑梗死 

分 类 号：R749.13[医药卫生—神经病学与精神病学]