豫北地区急性脑梗死患者卒中后抑郁危险因素分析  

Risk factors of post-stroke depression in patients with acute cerebral infarction in northern Henan province

作　　者：王旭生[1] 张萍[1] 曾皎 翁孝琴[2] 韩永凯[1] 张帆[1] 马金花 宋景贵[1] WANG Xusheng;ZHANG Ping;ZENG Jiao;WENG Xiaoqin;HAN Yongkai;ZHANG Fan;MA Jinghua;SONG Jinggui(Department of Neurology,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan Province,China;Department of Psychology,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453002,Henan Province,China)

机构地区：[1]新乡医学院第二附属医院神经内科,河南新乡453002 [2]新乡医学院第二附属医院心理科,河南新乡453002

出　　处：《新乡医学院学报》2020年第5期484-488,共5页Journal of Xinxiang Medical University

基　　金：河南省高等学校重点科研计划项目(编号:18A320033);河南省医学科技攻关计划项目(编号:201702130);河南省医学科技攻关计划省部共建项目(编号:SB201901063)。

摘　　要：目的探讨豫北地区首次急性脑梗死患者卒中后抑郁(PSD)的危险因素。方法选择2015年1月至2018年9月新乡医学院第二附属医院神经内科收治的首次发病急性脑梗死患者387例为研究对象。收集患者的人口学资料和临床资料,采用单因素分析PSD危险因素,将单因素分析结果中差异有统计学意义的指标进一步行单因素和多因素logistic回归分析,筛选PSD的独立危险因素。结果急性脑梗死患者在发病14 d至6个月PSD的患病率为47.0%(182/387)。单因素分析结果显示,患者的职业类型、性格、病灶部位、失语、脑梗死体积、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(ADL)评分与PSD有关(P<0.05);患者的年龄、性别、婚姻状况、文化程度、家庭收入、近期负性事件,高血压病、糖尿病、吸烟、饮酒、卒中家族史、颈动脉斑块与PSD无关(P>0.05)。单因素logistic回归分析结果显示,病灶部位、入院时NIHSS评分、性格、职业类型、失语是急性脑梗死发生PSD的危险因素(P<0.05);多因素logistic回归分析结果显示,患者入院时NIHSS评分、性格、病灶部位和失语是急性脑梗死发生PSD的独立危险因素(P<0.05)。结论豫北地区首次急性脑梗死后患者PSD发生率较高,患者入院时NIHSS评分、性格、病灶部位和失语是PSD发生的独立危险因素。Objective To investigate the risk factors of post-stroke depression(PSD)in patients with the first acute cerebral infarction in northern Henan.Methods Three hundred and eighty-seven patients with the first onset of acute cerebral infarction admitted to the Department of Neurology of the Second Affiliated Hospital of Xinxiang Medical University from January 2015 to September 2018 were selected as the study subjects.The demographic and clinical data of patients were collected,and then the risk factors of PSD were analyzed by univariate analysis.The indicators with statistically significant differences in univariate analysis results were further analyzed by univariate and multivariate logistic regression analysis to screen independent risk factors of PSD.Results The prevalence of PSD in patients with acute cerebral infarction from 14 days to 6 months after onset was 47.0%(182/387).The results of univariate analysis showed that the occupational type,personality,lesion site,aphasia,cerebral infarction volume,National Institute of Health stroke scale(NIHSS)score and activity of daily living scale(ADL)score of the patients were related to PSD(P<0.05);the age,gender,marital status,education level,family income,recent negative events,the history of hypertension,diabetes,smoking and alcohol consumption,the family history of stroke and carotid artery plaque were not related to PSD(P>0.05).The results of single factor logistic regression analysis showed that the location of the focus,NIHSS score at admission,personality,occupational type and aphasia were the risk factors of PSD in patients with acute cerebral infarction(P<0.05);the multivariate logistic regression analysis showed that NIHSS score,personality,lesion site and aphasia at admission were the independent risk factors of PSD in patients with acute cerebral i nfarction(P<0.05).Conclusion The incidence of PSD in the acute cerebral infarction patients with the first onset in northern Henan is higher.The NIHSS score at admission,personality,focus location and aphasia a

关 键 词：卒中后抑郁 脑梗死 危险因素 

分 类 号：R749.1[医药卫生—神经病学与精神病学]