急性脑卒中患者抑郁发生情况及相关因素研究

发布时间：2018-06-12 01:26

本文选题：脑卒中后抑郁 + 发生率　；参考：《皖南医学院》2013年硕士论文

【摘要】：目的：本文为揭示急性期PSD的高患病率并探讨其相关危险因素，以提高临床医生对PSD的重视，为早期诊断、早期治疗提供临床依据。方法：研究方案：采用病例－对照研究方案。病例资料采集方法：选择马鞍山十七冶医院神经内科和皖南医学院附属医院神经内、外科2011年1月至2011年12月住院的符合标准的急性期脑卒中患者120例。收集患者常规资料包括一般情况调查、既往病史、头颅CT或MRI检查。在患者发病第14天后，给予相关量表的评估。按照中国精神障碍类与诊断标准第3版（CCMD-3）抑郁症诊断标准及Hamilton抑郁量表评分，将患者分为抑郁组和对照组。神经功能缺损程度评分以采用美国国立卫生院卒中量表(NIHSS)，采用日常生活活动量表（ADL）评估生活能力,统计学处理：应用SPSS17.0统计软件，对单因素计量资料行t检验，Mann-Whitney U秩和检验，单因素计数资料采用χ2检验，，符合P0.05的因素采用二分类Logistic回归分析。结果：1共调查了120例患者，最后能够配合完成所有调查任务的有102例,PSD的发生率102例患者合并PSD46例，发生率45.1%；2.从脑卒中的特点来看，PSD的发生与卒中的性质，部位在统计学上无明显差异（P0.05），左半球、双侧半球、脑干部位可能是更易发生PSD；3PSD的发生率与性别、年龄、经济、职业、文化水平、糖尿病、高血压无显著相关性，但与配偶情况、合并症多有关；4研究发现NIHSS评分，ADL评分与PSD相关性明显，ADL评分高是PSD的保护因素。结论： PSD在脑卒中患者中发病率高，是脑卒中患者常见且严重的并发症。PSD的发生率与性别、年龄、经济、职业、文化水平、无显著相关性；但与神经功能缺损（NIHSS）和日常活动能力（ADL）相关性明显。PSD发生率可能与婚姻和脑血管危险因素有关，但还需要大样本研究。
[Abstract]:Objective: to reveal the high prevalence rate of PSD in acute stage and to explore its related risk factors in order to increase the attention of clinicians to PSD and to provide clinical basis for early diagnosis and early treatment. Methods: a case-control study was used. Methods: 120 patients with acute stroke who were hospitalized in Department of Neurology and affiliated Hospital of Southern Anhui Medical College from January 2011 to December 2011 in Maanshan Seventeenth Metallurgical Hospital were selected. Routine data were collected, including general investigation, past medical history, head CT or MRI examination. The patients were evaluated with the relevant scales 14 days after onset. Patients were divided into depression group and control group according to CCMD-3) and Hamilton Depression scale. The degree of neurological impairment was evaluated by the National Institutes of Health Stroke scale (NIHSSSS) and ADL (Daily living activity scale). Statistical analysis was performed with SPSS 17.0 statistical software, and Mann-Whitney U rank sum test was performed on the single factor measurement data. The data of single factor count were analyzed by 蠂 2 test, and the factors in accordance with P 0.05 were analyzed by logistic regression analysis. Results one hundred and twenty patients were investigated by 1: 1 and 102 cases of PSD were found to be able to cooperate with all the investigation tasks. The incidence of PSD was 46 cases in 102 cases (45.1%). According to the characteristics of stroke, there was no statistical difference in the occurrence and nature of PSD. The left hemisphere, bilateral hemispheres and brainstem may be more likely to occur PSD3PSD with sex, age, economy, occupation and education level. There was no significant correlation between diabetes mellitus and hypertension, but there was a significant correlation between NIHSS score and PSD, but there was a significant correlation between NIHSS score and ADL score. The higher ADL score was the protective factor of PSD. Conclusion: the incidence of PSD in stroke patients is high. The incidence of PSD is a common and serious complication in stroke patients. There is no significant correlation between PSD incidence and sex, age, economy, occupation, education level. The incidence of PSD may be related to marriage and cerebrovascular risk factors, but large sample study is needed.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3

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