卒中后情感障碍患者短期内PPPD发生的影响因素分析  

Analysis of influencing factors of Persistent postural-perceptual dizziness in patients with post-stroke affective disorder in the short term

作　　者：禹萌 周俊超 任雅芳 刘海涛[1] 张洪涛 YU Meng(Department of Neurology,Zhengzhou People’s Hospital,the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)神经内科,河南郑州450000

出　　处：《牡丹江医学院学报》2023年第4期55-58,80,共5页Journal of Mudanjiang Medical University

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191065)。

摘　　要：目的分析卒中后情感障碍患者短期内持续性姿势-感知性头晕(persistent posture-perceived dizziness,PPPD)发生的影响因素。方法对2021年1月至2023年1月期间于我院治疗并确诊为卒中后焦虑、抑郁或共病的100例患者展开回顾性分析,所有患者均随访3个月,依据是否发生PPPD分为PPPD组(n=36)和对照组(n=64),单因素和Logistic多因素分析卒中后情感障碍患者短期内PPPD发生的影响因素。结果PPPD组患者年龄>60岁、女性、高血压、血脂异常、医疗自费、家庭人均月收入<1000元的占比高于对照组,差异统计学有意义(P<0.05)。PPPD组患者的入院BI、出院BI、甘油三酯、淋巴细胞水平均低于对照组,出院美国国立卫生研究院卒中量表(NIHSS)评分、汉密尔顿焦虑评分量表(HAMA)、中性粒细胞、中性粒细胞/淋巴细胞比值、糖化血红蛋白(HbA1c)≥8.5%、高同型半胱氨酸(Hcy)>15μmol/L、抗血小板聚集治疗占比均高于对照组,差异统计学有意义(P<0.05)。年龄>60岁、女性、医疗自费、出院NIHSS评分升高、HAMA升高均为卒中后情感障碍患者短期内PPPD发生的影响因素(P<0.05)。结论年龄>60岁、女性、医疗自费、出院NIHSS评分升高、HAMA升高均为卒中后情感障碍患者短期内PPPD发生的影响因素,对高危患者应加强监控,积极采取有效措施改善预后。Objective To analyze the influencing factors of persistent posture-perceived dizziness(PPPD)in patients with post-stroke affective disorder.Methods A retrospective analysis was carried out on 100 patients with post-stroke anxiety,depression,or comorbidity who were treated in our hospital from January 2021 to January 2023.All patients were followed up for 3 months.They were divided into PPPD group(n=36)and control group(n=64).The factors affecting the occurrence of PPPD in patients with post-stroke affective disorder in the short term were analyzed by single factor and logistic multiple factors.Results The proportion of patients with age>60 years old,female,hypertension,dyslipidemia,medical expenses,and family monthly income per capita<1000 yuan in PPPD group was higher than that in the control group,and the difference was statistically significant(P<0.05).The admission BI,discharge BI,triglyceride,and lymphocyte levels of patients in PPPD group were lower than those in the control group.The discharge NIHSS score,HAMA,neutrophil quantity,neutrophil/lymphocyte ratio,Glycosylated hemoglobin(HbA1c)≥8.5%,Homocysteine(Hcy)>15μM and antiplatelet aggregation therapy was higher than that of the control group,and the difference was statistically significant(P<0.05).Age>60 years old,female,self-funded medical care,increased NIHSS score after discharge,and increased HAMA were all the influencing factors of PPPD in patients with the post-stroke affective disorder in the short term(P<0.05).Conclusion Age>60 years old,female,medical expenses,increased NIHSS score after discharge,and increased HAMA are all factors that affect the occurrence of PPPD in patients with the post-stroke affective disorder in the short term.We should strengthen the monitoring of high-risk patients and actively take effective measures to improve the prognosis.

关 键 词：脑卒中 情感障碍 持续性姿势-感知性头晕 因素 

分 类 号：R764.34[医药卫生—耳鼻咽喉科]