脑卒中后抑郁临床特征及其影响因素分析  

Analysis on clinical characteristics and influencing factors in post-stroke depression patients

作　　者：徐学兵[1] 刘粹[2] 孙太鹏 康岚[2] 孙丽君[2] 廖金敏[2] 谷朝霞[2] 王希林[2] 

机构地区：[1]宁夏精神卫生中心,宁夏银川750021 [2]北京大学精神卫生研究所,北京100191 [3]江苏省淮安市第三人民医院,江苏淮安223001

出　　处：《宁夏医学杂志》2016年第11期981-984,共4页Ningxia Medical Journal

基　　金：国家"十五"科技支撑计划项目(2009BAI77B06)

摘　　要：目的探讨脑卒中后抑郁患者的临床影响因素。方法应用《复合性国际诊断问卷-3.0》(CIDI-3.0)对405例住院脑卒中患者进行筛查与诊断,以脑卒中后抑郁患者作为研究组(PSD组),脑卒中后非抑郁患者为对照组(非PSD组),对2组患者家庭收入等一般资料及卒中性质等临床影响因素进行对照研究。结果研究组农村居民(86.4%与52.3%)、低收入家庭(81.8%与50%)的比例显著高于对照组(P<0.05);与对照组相比,研究组言语障碍(54.5%与22.7%,P<0.05)、肢体瘫痪(68.2%与40.9%,P<0.05)、脑出血(40.9%与9.1%,P<0.05)率更高。研究组卒中部位涉及基底节脑区的比率明显高于对照组,2组患者在婚姻状况、民族、受教育程度、职业、吸烟史、饮酒史、高血压病史、脑卒中发作次数及意识障碍方面比较差异无统计学意义(P>0.05)。结论脑卒中后抑郁的发生可能与卒中性质、部位(特别是基底节脑区)以及脑卒中导致的语言和运动功能受损有关,临床工作中应重视上述情况。此外,在卒中后抑郁的防治中应重视农村或低收入家庭的患者。Objective To explore the impact factors of patients with post - stroke depression, and to provide clinical reference for early recognition and intervention. Methods Comprehensive International Diagnostic Interview, core version 3.0 （ CIDI - 3.0 ） was used as a screening and diagnostic tool to evaluate 405 stroke patients. The patients diagnosed as post - stroke depression were classified into the experimental group （PSD group） and the patients of non -depression after stroke were classified into control group （Non -PSD group）. The general demographic information and clinical factors that impact upon stroke were Compared in two groups. Results The rate of post -stroke depression patients in rural （86.4% vs. 52.3% ） and low - income families （81.8% vs. 50% ） of experimental group were significantly higher thancontrol group （ P 〈 0.05 ）. Comparing to control group, the eases in experimental group had higher rates of lalopathy （54.5 %, 10/22 vs. 22.7%, P 〈 0.05 ）, body paralysis （68.2%, 15/22 vs. 40.9% ,P 〈 0.05 ）, and cerebral hemorrhage （40.9% ,9/22 vs. 9.1%, P 〈 0.05 ）. Location of stroke involving the basal ganglia in experimental group was significantly higher than that in control group （63. 6%, 14/22 vs. 34.1% ,P 〈 0.05 ）. There was no significant difference in maritM status, race, education level, occupation, smoking history, alcohol history, hypertension history, times of stroke and consciousness disorder between two groups （P 〈 0.05 ）. Conchlsion The occurrence of post - stroke depression may be related to the nature of stroke,location of stroke （ especially the basal ganglia）, and impairment in language and movement function after stroke. So we should pay more attention to the above situation in clinical work. In addition, we should also pay more attention to the patients in rural and low - income families in the prevention and treat- ment of post - stroke depression.

关 键 词：脑卒中 抑郁 临床特征 影响因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]