卒中后抑郁的危险因素多因素分析

Multiple factor analysis for poststroke depression’s risk factor

关键词:  PSD  危险因素  脑损伤部位

Key words:  poststroke depression  risk factor  lesion location

摘要:

［目的］探讨急性脑卒中后抑郁（poststroke depression,PSD）发病的危险因素。［方法］选择脑卒中患者50例，对所有患者依据CCMD-3进行诊断，然后进行Hamilton抑郁量表测试，分为三组。按starkstein法将病灶定位，采用多因素分析。［结果］①急性PSD发生率为62%，其中轻度抑郁占52%，中度抑郁占38%，重度抑郁占10%。②病灶最前点与额极的距离，以及病灶最后点与枕极的距离，均与抑郁症成负相关。③神经功能缺损的严重程度、合并症、经济状况是影响抑郁症的主要相关因素，而病灶所在的大脑半球、CT扫描上显示的陈旧病灶、性别、年龄、中风性质与抑郁症的发生无明显的相关性。［结论］PSD的发生率较高,且与躯体、心理、社会等多方面因素有关。

Abstract:

［Objective］To explore poststroke depression's risk factor.［Methods］In the present study ,50 patients were included who have had acute stuoke for no more than 1 week.All patients were investigated in a standardized manner , CCMD-3 and the Hamilton depression rating scales .They were divided into 3 groups .Based on starkstein'way, having had a multiple factor analysis for poststroke depression.［Results］①The prevalence rate of poststroke depression was 62% at the acute stage and mild ,moderate or severe depression as assessed by the HAMD were 52%,38% and 10% ,respectively.②The severity of depression correlated significantly with proximity of the lesion on CT scan to the frontal pole and the occipital pole. ③The severity of the neurological deficits,the quality of life ,and complications during the acute period were among the main relating factors in positive correlation with the severity the poststroke depression.There was no definite correlation between the severity of the poststroke depression and the location of the intracerebral stroke lesions,other ischemic lesions shown in the CT scans, and the patient's sexes and ages.［Conclusions］These findings support the notion that lesion location is associated with the depression ,although the nature of this association may be more complex than has previously been suggested.