卒中患者急性期的抑郁筛查及与卒中后抑郁相关因素的研究

发布时间：2018-04-14 08:39

本文选题：急性脑卒中 + 抑郁　；参考：《华中科技大学》2013年硕士论文

【摘要】：目的：研究急性脑卒中患者抑郁的发生情况以及与卒中后抑郁相关危险因素。方法：按照纳入标准及排除标准前瞻性纳入了86例来武汉协和医院神经内科入院的急性脑卒中患者。调查他们的所有的临床资料，填写病例登记本，采集外周血并低温保存待用。患者的一般资料包括性别、年龄、居住地、职业、卒中类型、卒中次数、习惯（吸烟、饮酒）、卒中家族史、是否患有高血压、糖尿病等其他疾病等，搜集并记录患者血样检测的各项指标包括胆固醇、甘油三酯、LDL-C、HDL-C、CRP、血沉，并采集患者的血液用ELISA法检测IL-6、TNF-α血清浓度。对每位患者脑卒中在发病两周内进行PHQ-9、简易智能状态检查表、NIHSS评分，根据PHQ-9评分把患者分为急性脑卒中伴抑郁组和急性脑卒中无抑郁两组。根据单因素分析方法，确定急性卒中伴发抑郁的危险因素。结果：86例脑卒中患者平均年龄为53.02±12.68岁，，急性脑卒中后2周的PHQ-9评分的平均值为4.49±4.46（变化范围为：0-17），脑卒中后2周内抑郁症状总的发生率为34.88%。单因素分析的结果显示：性格内向、高浓度的TNF-α、高血压、糖尿病是急性卒中后2周内伴发抑郁的危险因素。TNF-α可以做为预测急性脑卒中后抑郁的独立指标，当患者血清TNF-α浓度大于4.35pg/ml时，血清TNF-α浓度越高，脑卒中患者出现抑郁的可能性越大。本此研究中未发现性别、年龄、受教育程度、卒中类型、卒中家族史、其他合并症、居住地、职业、血脂水平、CRP、IL-6、MMSE评分与卒中后抑郁的发生相关。结论：性格内向、高的NIHSS评分、高浓度的TNF-α、高血沉、高血压、糖尿病是卒中患者在发病2周内伴发抑郁的高危因素。
[Abstract]:Objective: to study the incidence of depression in patients with acute stroke and the risk factors associated with post-stroke depression.Methods: 86 patients with acute stroke admitted to Department of Neurology Wuhan Union Hospital were included prospectively according to inclusion criteria and exclusion criteria.Survey all their clinical data, fill in case register, collect peripheral blood and cryopreservation for use.The general data included sex, age, place of residence, occupation, type of stroke, number of strokes, habits (smoking, drinking alcohol, family history of stroke, whether or not you have hypertension, diabetes, etc.)Blood samples were collected and recorded, including cholesterol, triglyceride (LDL-C), HDL-CU (CRP), erythrocyte sedimentation rate (ESR), and serum levels of IL-6 TNF- 伪 were detected by ELISA method.The patients were divided into acute stroke with depression group and acute stroke without depression group according to PHQ-9 score.According to univariate analysis, the risk factors of depression in acute stroke were determined.Results the average age of 86 stroke patients was 53.02 卤12.68 years old. The average PHQ-9 score of 2 weeks after acute stroke was 4.49 卤4.46 (range: 0-17). The total incidence of depression within 2 weeks after stroke was 34.88.Univariate analysis showed that introversion, high concentration of TNF- 伪, hypertension and diabetes were risk factors of depression within 2 weeks after acute stroke. TNF- 伪 could be used as an independent index to predict depression after acute stroke.When the concentration of TNF- 伪 was higher than that of 4.35pg/ml, the higher the concentration of TNF- 伪, the greater the likelihood of depression in stroke patients.Gender, age, education, type of stroke, family history of stroke, other complications, residence, occupation, and blood lipid level were not associated with poststroke depression.Conclusion: introversion, high NIHSS score, high concentration of TNF- 伪, high ESR, hypertension and diabetes are high risk factors for depression in stroke patients within 2 weeks.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3

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