脑梗死后抑郁发生与人文因素、血管危险因素及卒中特点的相关性研究  

Association of post-stroke depression with demographic factors,vascular risk factors and stroke features in Chinese elderly population

作　　者：王羚入[1] 符晓艳[1] 王华[1] 马瑞雪[1] 谭清华[1] 董茂渝 周华东[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《中华全科医学》2017年第2期286-288,共3页Chinese Journal of General Practice

基　　金：重庆市科技攻关计划项目(CSCS2008AB0011)

摘　　要：目的研究首次脑梗死后抑郁发生与人文因素、血管危险因素及卒中特点的相关性。方法采用Zung抑郁量表(SDS)对2010年1月—2014年12月于第三军医大学大坪医院就诊的304例首次脑梗死7 d内的患者在发病后第3个月进行评分,分为抑郁组125例和非抑郁组179例,分析2组患者脑梗死后抑郁的发生与人文因素、血管危险因素、卒中特点与发生抑郁的相关性。运用Logistic回归法分析首次脑梗死抑郁发生的危险因素。结果首次脑梗死后抑郁的发生率为41.1%。对抑郁组和非抑郁组患者在人文因素、血管危险因素及卒中特点等相关因素进行单因素分析,抑郁组患者在失眠、独居、近期负性事件、高血压、左颈内动脉系统梗死、皮质梗死、NIHSS和Bathel Index评分、语言障碍和运动障碍,与非抑郁组患者比较差异均存在统计学意义(均P<0.05)。多因素Logistic回归分析显示,失语(OR=1.82,95%CI 1.17~2.35)、失眠(OR=1.85,95%CI 1.20~2.42)、NIHSS评分(OR=2.19,95%CI 1.36~3.18)和Bathel Index评分(OR=2.27,95%CI 1.51~3.36)与脑梗死后抑郁的发生独立相关。结论失语、失眠、卒中严重程度是首次脑梗死抑郁发生的危险因素。Objective To study the association of post-stroke depression（ PSD） after first-ever ischemic stroke with demographic factors,vascular risk factors and stroke features in a large stroke cohort of China. Methods From January,2010 to December,2014,a total of 304 consecutive patients with a first episode of ischemic stroke within 7 days were enrolled in this study and divided into PSD group and non-PSD group according to Self-rating Depression Scale（ SDS） at the third month after stroke. The association of PSD with demographic factors,vascular risk factors,and stroke features were analyzed by univariate analysis and the risk factors of PSD were found by multivariable logistic regression analysis. Results The incidence of PSD after first-ever stroke was 41. 1%. When compared with the patients without PSD,those with PSD reported adverse life events more frequently,and more subjects with PSD lived alone,had left carotid artery infarction and cortical infarction,history of insomnia,hypertension,aphasia,dyskinesia,and high National Institute of Health Stroke Scale（ NIHSS） scores and low Barthel Index（ BI） scores（ P〈 0. 05）. The risk factors associated with PSD in logistic regression analysis were aphasia（ OR = 1. 82,95% CI： 1. 17- 2. 35）,insomnia（ OR = 1. 85,95% CI： 1. 20- 2. 42）,NIHSS score（ OR = 2. 19,95% CI： 1. 36- 3. 18） and Bathel Index score（ OR = 2. 27,95% CI： 1. 51- 3. 36）. Conclusion PSD is common in three months after stroke. The risk factors of PSD after the first-ever stroke are aphasia,insomnia,and neurological deficit degree.

关 键 词：卒中后抑郁 脑梗死 失眠 失语 卒中严重程度 

分 类 号：R749.13[医药卫生—神经病学与精神病学]