影响急性期脑梗死后抑郁状态的相关发病因素及其脑电图特点的研究

发布时间：2018-02-03 19:17

  本文关键词： 急性期脑卒中 急性期脑梗死后抑郁 抑郁程度 发病因素 脑电图　出处：《深圳大学》2017年硕士论文　论文类型：学位论文

【摘要】：脑梗死后抑郁(Post-cerebral-infarction Depression,PCID)为脑梗死后的常见精神类并发症。其临床表现为情绪消沉、兴趣减退,意识、失语和智能障碍等,医生无法对其详细问诊,加上缺乏特异性的检查手段,增加了PCID的误诊率和漏诊率。因此探究一种客观性、特异性水平高的PCID诊断方法,显得尤为重要。目的⑴采用HAMD量表测评以探讨影响急性期脑梗死后抑郁状态的相关因素。⑵通过分析急性期PCID患者的异常脑电活动,寻求诊断急性期PCID疾病的客观依据。⑶探讨急性期PCID患者的抑郁程度和病灶部位、脑电图之间的关系。⑷明确急性期PCID患者的异常脑电活动与HAMD量表测评结果一致,探讨急性期PCID的发病机制与生物-社会-心理因素相互作用的关系。方法选取深圳市第二人民医院神经内科就诊的急性期脑梗死患者,根据年龄和HAMD量表测评结果进行分组,并收集患者的电子病历。患者入院7天内进行脑电图检查,医师分析其异常脑电活动,用SPSS统计软件分析收集的数据。结果1.本文研究的急性期脑梗死患者321例,急性期脑梗死后无抑郁患者88例,急性期脑梗死后抑郁患者233例,急性期PCID的发病率为72.6%。2.急性期PCID发生的概率随着患者的教育程度升高而增加(P0.05),相对于教育程度较低的患者,教育程度较高的患者易发生急性期PCID;而急性期PCID与患者的年龄、性别无明显关系(P0.05)。3.高血压史与急性期PCID的发生有明显相关性(P0.05)。而急性期PCID与糖尿病史、饮酒史、吸烟史、合并症无明显相关性(P0.05)。4.病灶部位(基底节、放射冠)、病灶个数≥2,易发生急性期PCID(P0.05)。而其它病灶部位(额叶、颞叶、顶叶、枕叶)、脑梗死次数与急性期PCID无明显相关性(P0.05)。5.急性期PCID患者的脑电图易呈现低振幅α波和θ波(P0.05)。而急性期PCID患者脑电图中出现β波和δ波与急性期PCID的发生无明显相关性,其分布差异无统计学意义(P0.05)。6.急性期PCID患者的抑郁程度与病灶部位、病灶个数、脑梗死次数、异常脑电活动无明显相关性,其分布差异无统计学意义(P0.05)。结论急性期脑梗死患者的教育程度越高、高血压史、病灶部位(基底节和放射冠)、多病灶与急性期PCID的发生相关性较大。急性期PCID患者的脑电图易呈现低振幅α波和θ波脑电活动。急性期脑梗死患者的脑电图结果与HAMD量表测评的结果相一致,急性期PCID的发病机制由生物-社会-心理因素相互作用引起的。脑电图可作为急性期PCID疾病的辅助诊断方法,为急性期PCID的治疗提供新的评价、监测手段。
[Abstract]:Post-cerebral-#en0# after cerebral infarction. PCID is a common mental complication after cerebral infarction. Its clinical manifestations are depression, decreased interest, consciousness, aphasia and mental disorders, etc. Combined with the lack of specific means of examination, the misdiagnosis rate and missed diagnosis rate of PCID are increased. Therefore, an objective and highly specific diagnostic method of PCID is explored. Objective 1 to investigate the related factors of depression after acute cerebral infarction by using HAMD scale. 2. To analyze abnormal EEG activity in patients with acute PCID. Objective basis for the diagnosis of acute PCID disease. 3 to explore the degree of depression and the location of lesion in patients with acute PCID. The relationship between electroencephalogram (EEG). 4 it is clear that the abnormal EEG activity of PCID patients in acute stage is consistent with the results of HAMD scale. To explore the relationship between the pathogenesis of acute PCID and the interaction of biological, social and psychological factors. Methods the patients with acute cerebral infarction in the Department of Neurology, second people's Hospital of Shenzhen City were selected. The patients were divided into groups according to their age and the results of HAMD scale, and their electronic medical records were collected. The patients were examined by EEG within 7 days of admission, and their abnormal EEG activity was analyzed by physicians. The data collected were analyzed by SPSS software. Results 1. 321 patients with acute cerebral infarction and 88 patients with no depression after acute cerebral infarction were studied in this paper. 2. The incidence of PCID in acute stage was 72.60.2.The probability of PCID in acute phase increased with the increase of education level (P 0.05). Compared with the patients with lower education level, the patients with higher education level were more likely to develop acute PCID; In acute stage, PCID was associated with the patient's age. There was no significant correlation between sex and history of hypertension and PCID in acute stage. However, PCID in acute stage was associated with history of diabetes mellitus, history of drinking alcohol, and history of smoking. There was no significant correlation between the lesions (basal ganglia, coronal radiosurgery, the number of lesions 鈮，

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