缺血性脑卒中后16周患者抑郁发生以及严重程度的随访研究  

A 16-week Follow-up Study on the Incidence and Severity of Ischemic Post-stroke Depression

作　　者：袁永胜[1] 甘彩婷 章杰锦 徐勤荣[1] 袁勇贵[2] 张克忠[1] YUAN Yong-sheng;GAN Cai-ting;ZHANG Jie-jin;XU Qin-rong;YUAN Yong-gui;ZHANG Ke-zhong(Department of Neurology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Psychosomatics&Psychiatry,the Affiliated Zhongda Hospital of Southeast University,Nanjing 210009,China)

机构地区：[1]南京医科大学第一附属医院神经内科,南京210029 [2]东南大学附属中大医院心理精神科,南京210009

出　　处：《中国临床神经科学》2021年第5期543-547,共5页Chinese Journal of Clinical Neurosciences

基　　金：江苏省科技创新与成果转化(生命健康科技)专项资金(编号:BL2012025);国家自然科学基金(编号:81901297,81671258)。

摘　　要：目的研究脑卒中后患者抑郁(PSD)发生状况以及严重程度的演变规律。方法选取连续收治的符合入组标准的48例缺血性脑卒中住院患者进行16周随访研究,于脑卒中后1周行神经功能缺损量表(NIHSS)、Barthel指数(BI)、社会支持评定量表(SSRS)评估患者神经功能缺损程度、日常生活活动能力以及社会支持情况。脑卒中后1、2、4、8、12和16周分别行汉密尔顿抑郁量表(HAMDS)评估患者抑郁情况,根据不同时间点的HAMDS评分动态判定患者是否为PSD,并据此分为PSD组和非PSD组。结果脑卒中后2周PSD发生率(52.1%)达峰值,之后呈下降趋势。PSD患者第2周HAMD评分达峰值平均(15.14±4.28)分,之后逐渐下降,第16周降至(10.00±2.20)分。脑卒中后1周PSD(HAMDS评分≥8分)组为24例(50%),脑卒中后1周PSD组NIHSS评分显著高于非PSD组,BI指数、SSRS评分显著低于非PSD组,差异均有统计学意义(均P<0.05);HAMDS评分与NIHSS评分呈正相关,与BI、SSRS评分呈负相关(P<0.05)。结论经16周随访发现,PSD发生状况及严重程度呈动态变化过程;PSD的发生与神经功能缺损、日常生活活动能力、社会支持有密切关系。Aim To investigate the progress of the incidence and severity of post-stroke depression(PSD).Methods Forty-eight continuous hospitalized patients with ischemic stroke who met the inclusion criteria were enrolled in the study and completed the 16 weeks follow-up.All the participants were evaluated by NIH Stroke Scale(NIHSS),Barthel index of ADL(BI)and Social Support Revalued Scale(SSRS)at 1 week after onset.The Hamilton Depression Scale(HAMD)was used to screen depression,which was evaluated at 1 week,2 weeks,4 weeks,8 weeks,12 weeks and the end of the 16 weeks,respectively.According to the HAMD score at different time points,whether the patients were PSD group was dynamically judged.Results The highest incidences of PSD were 52.1%at 2 weeks after stroke.The HAMD scores of PSD patients peaked(mean scores 15.14±4.28)in the second week,and then decreased overtime(dropped to 10.00±2.20 in the 16 th week).One week after stroke,50%of stroke patients had HAMD score≥8.At this time point,they were divided into PSD group(24 cases).One week after stroke,the scores of NIHSS were significantly higher in PSD patients than in non-PSD(P<0.05).The scores of BI and SSRS were significantly lower in PSD than in non-PSD group(P<0.05).Correlation analysis indicated that HAMD scores were positively associated with NIHSS scores as well as negatively correlated with BI and SSRS scores(P<0.05).Conclusion The incidences and severity of PSD showed dynamic changes.The PSD occurrence was correlated with neurologic impairment,activities of daily living and social support.

关 键 词：脑卒中后抑郁 发生状况 严重程度 演变规律 

分 类 号：R743[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]