阿替普酶静脉溶栓治疗急性脑梗死后发生卒中后抑郁的影响因素分析  

Influencing factors for post-stroke depression in patients with acute cerebral infarction treated by intravenous thrombolysis with alteplase

作　　者：任毅[1] 高小平[1] 梁辉[1] REN Yi;GAO Xiao-Ping;LIANG Hui.(Department of Neurology, The People＇s Hospital of Hunaa Province, Changsha 410000, China)

机构地区：[1]湖南省人民医院神经内科,湖南省长沙市410000

出　　处：《国际神经病学神经外科学杂志》2018年第3期277-280,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的分析急性脑梗死(ACI)患者采用阿替普酶静脉溶栓治疗卒中后抑郁(PSD)的发生率和严重程度的影响因素。方法以2015年2月至2017年1月我院收治的符合标准的375例ACI患者为研究对象,按照是否溶栓分为溶栓组(n=190)与非溶栓组(n=185),随访6个月后采用HAMD-17评分判定PSD的发生及严重程度,同时采用自制调查表收集各项临床资料,并对影响因素与PSD的发生及严重程度的相关性进行分析。结果 375例ACI患者中共发生130例PSD;溶栓组47例(轻度27例、中度16例和重度4例),非溶栓组83例(轻度43例、中度28例和重度12例);2组PSD的发生率(χ~2=6.320,P=0.021)及严重程度(Z=-2.151,P=0.032)差异明显。护理人员(r=-2.105,P=0.018)、mRS评分(r=1.810,P=0.018)及是否溶栓(r=-1.866,P=0.012)是PSD发生的影响因素;护理人员(χ~2=14.476,P=0.001)与mRS评分(t=3.876,P=0.000)对PSD严重程度的影响明显;护理人员对非溶栓组PSD严重程度的影响明显(χ~2=6.856,P=0.014);mRS评分对溶栓组(t=2.331,P=0.022)与非溶栓组(t=2.990,P=0.009)PSD严重程度的均有明显影响。结论阿替普酶静脉溶栓可以降低PSD的发生率及严重程度;护理人员(家属)及较低mRS评分是PSD的保护因素。Objective To analyze the influencing factors for the incidence and severity of post-stroke depression （PSD） in patients with acute cerebral infarction （ACI） treated by intravenous thrombolysis with alteplase. Methods Three hundred and seventy-five eli- gible patients with ACI who were admitted to our hospital from February 2015 to January 2017 were enrolled as research subjects. All patients were divided into thrombolysis group （n = 190） and non-thrombolysis group （n = 185 ） according to whether thrombolytic therapy was adopted. The development and severity of PSD were evaluated using HAMD-17 scores after 6 months of follow-up. In the meantime, the clinical data were collected by a self-made questionnaire, and the association between influencing factors and the devel- opment and severity of PSD was analyzed. Results There were 130 cases of PSD in 375 patients with ACI, in which 47 cases were in the thrombolysis group （27 cases of mild PSD, 16 cases of moderate PSD, and 4 cases of severe PSD）, and 83 cases were in the nonthrombolysis group （43 cases of mild PSD, 28 cases of moderate PSD, and 12 cases of severe PSD）. The incidence （χ2 = 6.320, P = 0.021 ） and severity （Z = -2. 151, P = 0. 032） of PSD were significantly different between the two groups. The nursing staff （r = -2. 105, P=0.018）, mRS score （r = 1. 810, P =0. 018）, and whether or not to adopt thrombolytic therapy （r = - 1. 866, P = 0.012） were influencing factors for the development of PSD. The nursing staff （χ2= 14. 476, P = 0.001 ） and mRS score （ t = 3. 876, P = 0. 000） had a significant effect on the severity of PSD. The nursing staff had a significant effect on the severity of PSD in the nonthrombolytic group （χ2 = 6. 856, P =0. 014） ; the mRS score had a significant effect on the severity of PSD in both the thrombolysis group （t =2.331, P=0.022） and the non-thrombolysis group （t =2.990, P=0.009）. Conclusions Intravenous thrombolysis with alteplase can reduce the incidence and sev

关 键 词：急性脑梗死 卒中后抑郁 阿替普酶 静脉溶栓 

分 类 号：R473.74[医药卫生—护理学]