缺血性脑卒中NIHSS评分与卒中抑郁的相关性分析  

The correlation analysis of NIHSS score of patients with ischemic stroke and post-stroke depression

作　　者：袁波[1] 谭莉[1] 李鑫[1] 万芳超 YUAN BO;TAN LI;LI Xin;WAN Fangchao(The Neurology Department of Brain Hospital of Hunan Provinc,Changsha Hunan 410007,China)

机构地区：[1]湖南省脑科医院神经内科,410007 [2]湖南中医药大学附属人民医院神经内科

出　　处：《中国神经免疫学和神经病学杂志》2018年第6期430-432,461,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：湖南省卫生计生委科研支撑项目(C2016017)

摘　　要：目的探讨缺血性脑卒中患者美国国立卫生研究院卒中量表(NIHSS)评分与卒中后抑郁(PSD)的相关性。方法选择2017-10—2018-10期间在湖南省脑科医院就诊的缺血性脑卒中患者150例,收集病史资料及NIHSS评分,并跟踪观察1个月,以中国精神障碍诊断和分类标准第3版(CCMD-3)的抑郁诊断标准诊断PSD,采用汉密尔顿抑郁量表(HAMD,17项版本)评估抑郁症状的严重程度。将研究对象分为非PSD组(HAMD评分≤6分)和PSD组(HAMD评分>7分),再将PSD组进一步分为轻度抑郁亚组(HAMD评分>7分且≤16分)、中-重度抑郁症亚组(HAMD评分≥17分)。计算PSD患病率,并分析影响PSD患病率的相关因素(性别、高血压、糖尿病、高血脂、房颤、吸烟、饮酒、既往有无脑卒中史),以及抑郁症状的严重程度(HAMD评分)与NIHSS评分的相关性。结果缺血性脑卒中后1个月内PSD的患病率为34.0%(51例),其中轻度抑郁症状患者占64.7%(33例)。PSD组既往脑卒中史的构成比(83.3%)显著高于非PSD组(30.3%;P<0.05)。PSD组NIHSS评分与HAMD评分具有相关性(OR=5.231,95%CI=1.204～10.154,P=0.01)。结论 PSD以轻度抑郁症状为主,既往有脑卒中病史者患病率高,且NIHSS评分与抑郁症状的严重程度具有相关性,NIHSS评分越高,PSD患病几率越大。Objective To investigate the correlation between the National Institutes of Health Stroke Scale(NIHSS)score and Post-Stroke Depression(PSD)of ischemic stroke patients.Methods We collected the medical history and NIHSS score of 150 ischemic stroke patients admitted to the Brain Hospital of Hunan province from October 2017 to October 2018.We followed them for a month to assess the severity of depressive symptoms by Hamilton Depression Rating Scale(HAMD,17 version).According to the Chinese Classification of Mental Disorders Version 3(CCMD-3)diagnostic criteria for the clinical diagnosis of PSD,these individuals were divided into either a non-PSD group(HAMD scores were equal or less than 6 points)or a PSD group(HAMD scores were equal or greater than 7 points).The PSD group was further divided into a mild depression subgroup(HAMD scores were equal or greater than 7 points but equal or less than16 points)or a moderate/severe depression subgroup(HAMD scores were equal or greater than 17 points).We measured the prevalence of PSD and analyzed the factors that influenced its prevalence,including gender,hypertension,diabetes,hyperlipidemia,atrial fibrillation,smoking,drinking alcohol,and previous history of stroke.Finally,we analyzed the correlation between the severity of depression and NIHSS score.Results Within 1 month of ischemic stroke,34%of the 150 individuals were diagnosed with PSD(51 patients),64.7%(34 patients)of which were deemed to have mild depression.The PSD group with a previous history of stroke accounted for 83.3%,which was significantly higher than the non-PSD group(30.3%,P<0.05).NIHSS score was determined to have a positive correlation with HAMD rating scale score(OR=5.231,95%CI=1.204~10.154,P=0.01).Conclusions The majority of ischemic stroke patients diagnosed with PSD were found to have mild depression,and the ischemic stroke patients with a previous history of stroke were more likely to be diagnosed with PSD.These results suggest that NIHSS score correlates with PSD severity in that a higher NIHSS scor

关 键 词：NIHSS评分 卒中后抑郁 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]