脑卒中后恢复期患者抑郁影响因素和筛查效果分析  

Influencing factors and screening effect of depression in convalescent patients after stroke

作　　者：洪婉婷 孙秀丽 鲍兰军 杨南华 陈骕 管晓波[2] 施敏[2] Hong Wanting;Sun Xiuli;Bao Lanjun;Yang Nanhua;Chen Su;Guan Xiaobo;Shi Min(Department of Geriatric Rehabilitation,Shanghai Second Rehabilitation Hospital,Shanghai 201900,China;Rehabilitation Ward Three,Shanghai Third Civil Mental Center,Shanghai 200435,China)

机构地区：[1]上海市第二康复医院老年康复科,上海201900 [2]上海市民政第三精神卫生中心康复三病区,上海200435

出　　处：《临床荟萃》2020年第12期1101-1105,共5页Clinical Focus

基　　金：上海市宝山区医学卫生项目——通督安神针刺法联合团体认知认知行为治疗对脑卒中恢复期患者睡眠质量的影响及多模态脑机制(18-E-39)。

摘　　要：目的探讨脑卒中后恢复期患者抑郁情况的分布及影响因素和抑郁自评量表量表对抑郁障碍的筛查效果。方法纳入脑卒中后恢复期患者43例,采集人口统计学、心率、高血压病、BMI、糖化血红蛋白、血胆固醇、血甘油三酯、凝血因子活性结果,予焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠指数量表(PSQI)测量患者的焦虑、抑郁和睡眠质量情况,建立回归模型观察纳入变量对SDS量表评分的影响。结果43例中评分指数达到抑郁者14例(32.6%)。回归分析显示发现,HbA1c(β=4.01,P<0.01)与PSQI(β=0.83,P<0.05)对SDS量表评分有显著性影响,且HbA1c回归系数较大。ROC曲线诊断发现ROC曲线下面积AUC为0.841(95%CI:0.713-0.969,P<0.01),最佳界值40.5,Youden指数0.592,敏感性69.2%,特异性90%。结论临床上应对脑卒中后高血糖、睡眠质量差者进行及时筛查和干预。SDS量表能有效筛查患者的抑郁障碍。Objective To investigate the distribution and influencing factors of depression in convalescent patients after stroke and the screening effect of self-rating depression scale(SDS)on depressive disorder.Methods A total of 43 patients in convalescence after stroke were included.The results of demography,heart rate,hypertension,BMI,glycosylated hemoglobin,blood cholesterol,blood triglyceride and coagulation factor activity were collected.Anxiety,depression and sleep quality were measured by Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI).A regression model was established to observe the influence of the included variables on the SDS scores.Results Of the 43 cases,14 cases(32.6%)had a score of depression.The regression analysis showed that HbA1c(β=4.01,P<0.01)and PSQI(β=0.83,P<0.05)had significant influence on SDS score,and the regression coefficient of HbA1c was relatively large.ROC curve diagnosis revealed that the area under the ROC curve(AUC)was 0.841(95%CI:0.713-0.969,P<0.01),the best cut-off value was determined as 40.5,Youden index was 0.592,with a sensitivity of 69.2%and a specificity of 90%.Conclusion Clinically,patients with high blood sugar and poor sleep quality after stroke should be screened and intervened in time.SDS scale can effectively screen for depressive disorder in patients.

关 键 词：脑血管意外 抑郁 康复 因素分析 统计学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]