不同临床类型脑卒中后抑郁症患者健康相关生存质量及其影响因素  

Study on health-related quality of life and its influencing factors in patients with different types post-stroke depression

作　　者：郝贵峰[1] 李修奎 胡晋怀[1] 张继香[1] 王师华[1] 季涛[1] 刘伟[1] 吕晶[1] 

机构地区：[1]山东省临沂市人民医院,276003 [2]山东省临沂市肿瘤医院

出　　处：《精神医学杂志》2012年第6期432-435,共4页Journal of Psychiatry

基　　金：临沂市科技发展计划项目(编号:201013018)

摘　　要：目的探讨不同临床类型脑卒中后抑郁症(post-stroke depression,PSD)患者健康相关生存质量(health-related quality of life,HRQOL)及其影响因素。方法筛选在临沂市人民医院康复科住院康复期首发缺血性脑卒中患者203例(单纯脑卒中患者105例,PSD患者98例)进行问卷测试。将患者依据临床类型分为4组,完全前循环梗死(TACI)组62例,部分前循环梗死(PACI)组58例,后循环梗死(POCI)组55例,腔隙性梗死(LACI)组28例。结果 (1)PSD发生率:PSD总体发生率为48.28%;TACI组、PACI组、POCI组和LACI组PSD发生率分别为56.45%、53.45%、47.27%和21.43%,组间差异具有显著性(χ2=10.386,P=0.016);(2)PSD患者和单纯脑卒中患者除上肢功能和视力无显著性差异外,HRQOL其他各项因子及整体差异具有显著性(P<0.05或P<0.01);(3)4种不同临床类型PSD患者的HRQOL,除上肢功能和视力外,其他各项因子及总得分差异均有显著性(P<0.05或P<0.01);(4)在PSD患者中,女性、未婚或丧偶、高中以上文化程度、农村、家庭月收入<2 000元和由护工照顾的患者较相应对照组患者及神经功能缺损程度越高和抑郁程度越严重的患者HRQOL明显差(P<0.05或P<0.01)。结论 PSD发生率较高,不同临床类型脑卒中患者PSD发生率显著不同;PSD患者较单纯脑卒中患者HRQOL明显差;不同临床类型PSD患者HRQOL不同;女性、未婚或丧偶、高中以上文化程度、来自农村、家庭月收入<2 000元、神经功能缺损程度越高、由护工照顾及抑郁程度越重等是影响PSD患者HRQOL的不利因素。Objective To investigate the heahh-related quality of life （HRQOL） and its influencing factors in patients with different clinical-types post-stroke depression stroke in rehabilitation department of people＇s hospital of （PSD）. Methods 203 patients with iirst-eplsode lSchemlc [inyi city were divided into total anterior circulation infarct group （TACI group, 62cases）, partial anterior circulation infarct group group （POCI group, 55 cases） and lacuna infarct group （ LACI group, （PACI, 58 cases）, posterior circulation infarct 28 cases）. All patients were investigated with general information questionnaire, Hamilton Depression Scale （HAMD）, Symptom .Checklist-90 items （SCL-90）, Chinese Scale of Neurologic Deficit, and Stroke-specific Quality of Life （SS-QOL）. Results （1） The prevalence of PSD was 48.28% （98 cases） totally and was 56.45% , 53.45% 47.27%, 21.43% in TACI group, PACI group, POCI group and LACI group respectively. There was significant difference among the four groups （X2 = 10. 386, P = 0.016）. （2） Compared with patients with simple stroke, there were significant differences in total score and factor scores of HRQOL except in the item of upper limb function and visual acuity in patients with PSD （P 〈 0. 05 or 0.01 ）. （3） There were significant differences in total score and factor scores of HRQOL except in the item of upper limb function and visual acuity among TACI group, PACI group, POCI group and LACI group （ P 〈 0. 05 or 0.01 ）. （4） Scores of I-IRQOL were significantly lower in females, singles, patients with high school education and above, patients lived in countryside, low income people, patients need caregivers, patients with serious neurologic impairment and patients with serious depressive symptoms （P 〈 0. 05 or 0.01 ）. Cortdusion The prevalence of PSD is high in patients with ischemic stroke and it is different in different clinical-types of stroke. HRQOL in patients with PSD is worse than that in simple stroke and H

关 键 词：脑卒中后抑郁症 健康相关生存质量 

分 类 号：R749.4[医药卫生—神经病学与精神病学]