首发脑梗死患者卒中后抑郁与卒中部位的关系  

The relationship between poststroke depression and stroke lesions.

作　　者：张长青[1,2] 方向华[1] 刘宏军[1] 王蔚华[1] 张新卿[3] 李宁燕 

机构地区：[1]首都医科大学宣武医院流行病学和社会医学部,北京100053 [2]北京市普仁医院神经内科 [3]首都医科大学宣武医院神经内科,北京100053 [4]北京市宣武区广外医院内科

出　　处：《中国神经精神疾病杂志》2009年第3期148-151,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:30671797)

摘　　要：目的研究首次发病的脑梗死患者卒中后抑郁(PSD)与卒中部位之间的关系。方法选取340例经CT/MR确诊的脑梗死患者,其中169例抑郁自评量表指数大于或等于0.5者为PSD组,采用2检验和Logistic回归分析PSD与卒中部位之间的相关性。结果脑梗死患者PSD的患病率为49.7%(169/340),其中额叶卒中患者PSD的患病率为66.7%,其他部位卒中患者PSD患病率为47.3%,两者差异有统计学意义(2=5.51,P=0.02)。分层及回归分析显示额叶卒中是卒中6个月内PSD患病的独立危险因素,调整年龄、文化程度、梗死类型、患高血压、患心脏病、日常生活活动能力评分、认知功能后,额叶卒中患者PSD的患病风险是其他部位卒中患者的2.42倍(P=0.02,RR=2.42,95%C I:1.17-5.03)。结论脑梗死患者PSD的患病率较高,额叶卒中患者在卒中后6个月内有更高的PSD患病风险。Objective To study the relationship of poststroke depression （PSD） and stroke lesions. Methods We analyzed the relationship between PSD and stroke lesions through Chi square test and Logistic regression in 340 patients with first-ever cerebral infarction diagnosed by cranium CT or MR. Results The total prevalence of PSD in our stroke population was 49. 7%. The prevalence of PSD in stroke patients with frontal lobe lesion and those with other stroke lesion were 66.7% and 47. 3% respectively. There was a significant difference in the prevalence of PSD between stroke patients with frontal lobe lesion and those with other stroke lesions （ χ^2 =5.51 ,P =0. 02）. Cerebral infarction in frontal lobe significantly correlated with PSD within 6 months after stroke （ χ^2 = 9.23,P 〈 0. 01 ） whereas stroke lesions in left or right hemisphere did not correlate with PSD. After adjustment of age, education level, subtype of stroke, hypertension, heart disease, activity of daily living and cognitive function, the risk of PSD was 2. 42 times higher in stroke patients with frontal lobe lesion than in those with other stroke lesion. Conclusions There is a high prevalence of PSD in cerebral infarction patients and patients with frontal lobe stroke lesion have a higher risk of PSD than those with other stroke lesion within 6 months after onset of stroke.

关 键 词：脑梗死 卒中后抑郁 患病率 卒中部位 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]