老年缺血性脑卒中后抑郁及与痴呆的相关性  

Correlation between Depressive Disorder with Dementia after Ischemic Stroke in Elderly Patients

作　　者：郭瑞友[1] 李吉柱[2] 赵丽霞[1] 毛德军[1] 藏云华[1] 刘前[1] 

机构地区：[1]青岛大学医学院附属海慈医院神经内科,山东青岛266033 [2]青岛市精神卫生中心,山东青岛266034

出　　处：《中国康复》2010年第5期334-336,共3页Chinese Journal of Rehabilitation

基　　金：青岛市科技局科技计划项目(06-2-2-4-nsh)

摘　　要：目的:探讨老年缺血性脑卒中患者卒中后抑郁(PSD)的发病率、预测因素及与痴呆的关系。方法:对在同1年内住院的老年缺血性卒中患者进行流行病学调查,共入选符合条件的患者142例,记录其年龄、性别、家庭照料情况、婚姻状况等人口学资料及头颅影像学特征,评定患者神经功能缺损程度(NIHSS)及ADL(FIM);发病后3个月进行简易智能状态检查量表(MMSE)、抑郁量表(CES-D)及汉密尔顿抑郁量表(HAMD)评定患者抑郁程度和认知状态。以卒中后PSD为因变量,以与非PSD患者有显著差异的项目为自变量,进行多元逐步Logistic回归分析;同时以有无痴呆为因变量,以PSD等为自变量进行回归分析。结果:与健康人群(85例)比较,142例脑卒中患者患轻中度PSD的人数明显增多(3.5%与18.3%,P<0.01);脑卒中患者中PSD患者并发痴呆发病率显著高于非PSD患者。Logistic回归分析显示,PSD的预测因素是缺乏家人照料、痴呆、神经功能缺损重和ADL能力差,未发现PSD是痴呆有意义的影响因素。结论:PSD的发病率低于前期有关报道,脑卒中后痴呆是PSD的预测因素,但PSD不是痴呆的预测因素。Objective： To investigate the incidence and predicted factors of post-stroke depression（PSD） and its correlation with dementia after ischemic stroke in elderly patients.Methods： We examined 142 elderly patients with ischemic stroke and 85 age-and sex-matched controls from the general population.In a self-designed register form,age,sex,education,marital status,whether the person was living with relatives,CT or MIR scans,NIHSS,FIM,MMSE and HAMD were recorded.A multiple factor analysis with the logistic regression method was carried out on the basis of these data.Results： The incidence of PSD and dementia was 18.30% and 16.90 respectively after ischemic stroke in elderly patients.Stepwise regression analysis showed that the depression important predictive factors involved the relationship with relatives,dementia,NIHSS and FIM.Dementia predicted depression,but PSD was not the predictive factor of dementia.Conclusion： Depression may be less frequent than previously reported after ischemic stroke and the dementia was the predictive factor of PSD but the reverse did not hold.

关 键 词：缺血性卒中 老年 抑郁 痴呆 

分 类 号：R743.3[医药卫生—神经病学与精神病学]