脑梗死急性期疲劳与血尿酸、血糖、抑郁及功能障碍的相关性分析  

Correlation of fatigue during the acute stage of stroke with serum uric acid and glucose levels, depression,and disability

作　　者：吴丹[1,2] 王林[2] 滕伟禹[1] 商秀丽[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,沈阳110001 [2]沈阳市红十字会医院神经内科

出　　处：《中华临床医师杂志（电子版）》2013年第23期44-47,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81100243);辽宁省博士科研启动基金(20101142);辽宁省科技厅科学技术计划项目(2011225020);辽宁省教育厅基金(L2013296)

摘　　要：目的明确卒中急性期疲劳与血尿酸(UA)、血糖、抑郁及功能障碍的相关性,探讨卒中后疲劳(post-stroke fatigue,PSF)可能的相关因素。方法病例组来自2012年6月至2013年9月在沈阳市红十字会医院神经内科住院治疗的急性脑梗死患者,共312例。对照组为我院健康体检中心同期的健康体检者,共312人。用疲劳严重度量表(Fatigue Severity Scale,FSS)评价疲劳的状况,FSS评分≥4分诊断为疲劳。据此将病例组分为疲劳组(F组)与非疲劳组(NF组)。用抑郁自评量表(Self-rating Depression Scale,SDS)评价抑郁的程度,SDS评分≥50分诊断为抑郁。用NIHSS评分来评价卒中的严重程度,用MRS评分评价患者功能障碍的程度。记录患者的年龄、性别及慢性病史,并于患者入院后第二天检测血糖及UA水平。结果病例组疲劳的发病率(40.4%)明显高于对照组(4.8%),差异有统计学意义(χ2=112.892;P<0.001)。在病例组中,F组抑郁的发病率、MRS评分及血糖水平均明显高于NF组,而UA水平则明显低于NF组(P<0.001)。两组的年龄、性别、慢性病史及NIHSS评分无明显差别(P>0.05)。在F组中,MRS评分、SDS评分及血糖水平与FSS评分成正相关(P<0.001),UA水平与FSS评分成负相关(P<0.001),而年龄和NIHSS评分与FSS评分无关(P>0.05)。结论在脑梗死急性期疲劳与UA、血糖、抑郁及功能障碍的水平密切相关。这为研究PSF的病因及发病机制提供了理论依据,为探索PSF的治疗开拓了新的思路。Objective To clarify the correlation between fatigue during the acute stage of stroke with serum uric acid and glucose levels, depression, and disability, and to determine the possible factors related to post-stroke fatigue （PSF）. Methods The case group of 312 patients with acute cerebral infarction were recruited from the Department of Neurology at Shenyang Red Cross Hospital in China between June 2012 and September 2013. The control group of 312 persons were recruited from the Health Examination Center of the hospital during the same period. Fatigue was assessed using the Fatigue Severity Scale （FSS）. The patients of the case group were divided into fatigue （F group） and non-fatigue groups （NF group） based on the FSS score. Patients with a FSS score≥4 points were defined as having fatigue. Depression was assessed using the Self-rating Depression Scale （SDS）. Patients with a SDS score≥50 points were defined as having depression. Stroke severity and the level of disability were assessed with the National Institutes of Health Stroke Scale （NIHSS） and the modified Rankin Scale （MRS）, respectively. We recorded age, gender, disease history, and determined the serum uric acid （UA） and glucose levels. Results The incidence of fatigue in the case group （40.4%） was higher than that in the control group （4.8%） （χ2=112.892;P＆lt;0.001）. Within the case group, the F group had a higher incidence of depression, a higher serum glucose level, a higher MRS score, and a lower serum UA level compared to the NF group （P＆lt;0.001）. Age, gender, chronic disease history, and the NIHSS score were not significantly different between the two groups （P＆gt;0.05）. In the F group, the MRS score, SDS score, and serum glucose level were positively correlated and the serum UA level was negatively correlated with the FSS score （P＆lt;0.001）. Age and the NIHSS score were not significantly correlated with the FSS score （P＆gt;0.05）. Conclusions The serum UA and glucose levels,

关 键 词：卒中 疲劳 尿酸 血糖 抑郁 功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]