脑卒中后抑郁发生的相关因素分析及应用SPECT探索其发病机制

发布时间：2018-02-24 22:28

本文关键词： 脑卒中卒中后抑郁相关因素局部脑血流量发病机制　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]通过评价脑卒中患者的卒中性质、病程时间、神经功能缺损程度和社会支持度,分析影响患者卒中后抑郁(post-stroke depression,PSD)发生的相关因素,应用单光子发射计算机断层扫描术(single photon emission computed tomography,SPECT)测量卒中患者的局部脑血流量(regional cerebral blood flow,rCBF),探索PSD的发病机制。[方法]随机收集48例脑卒中患者的卒中性质和病程时间信息,并按病程时间(1月、1-2月、2-3月、3月)将病人分为4组,应用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评估患者的神经功能缺损程度,社会支持度量表(Social Support Rating Scale,SSRS)评价患者的社会支持度,以及脑卒中抑郁量表(Post-Stroke Depression Scale,PSDS)评定患者的抑郁程度,分析患者PSD发生的相关因素。应用SPECT技术检测脑卒中患者各脑区的rCBF值,分析PSD发生与不同脑区rCBF之间的相关性,探索PSD的发病机制。[结果]1.卒中性质与PSD的发生无明显相关性,P=0.5720.05,无统计学意义。2.不同病程时间与PSDS评分之间无显著相关性(P=0.4100.05)。组别之间患者的抑郁情况也无显著性差异,P均0.05,无统计学意义。3.脑卒中患者的神经功能缺损程度与卒中后抑郁评分无显著相关性(P=0.1140.05)。4.脑卒中患者的社会支持度评分与卒中后抑郁评分无明显相关性(P=0.2440.05)。5.右侧基底节区局部脑血流值与PSD的发生具有显著相关性(P=0.0140.05),Pearson相关系数=-0.424,呈负性相关。其余部位脑血流量的改变与PSD的发生无显著相关性(P值均0.05)。[结论]1.患者的卒中性质、病程时间、神经功能缺损程度、社会支持度与PSD的发生无明显相关性。2.患者PSD的发生可能是由于右侧基底节区血流量的下降所致。
[Abstract]:[objective] to evaluate the nature of stroke, duration of stroke, degree of neurological impairment and degree of social support in stroke patients, and to analyze the related factors affecting post-stroke depression (PSD). Single photon emission computed tomographygraphy (SPECT) was used to measure regional cerebral blood flow rCBFN in patients with stroke, and to explore the pathogenesis of PSD. [methods] 48 patients with stroke were randomly collected for information on the nature and duration of stroke. The patients were divided into 4 groups according to the duration of the disease course (January, January-February to Jan.2-3, March). The National Institute of Health Stroke scale (NIHSS) was used to evaluate the degree of neurological impairment in the patients. The Social Support Rating scale (SSRS) was used to evaluate the degree of social support, and the Post-Stroke Depression scale (PSDSs) to assess the degree of depression, and to analyze the factors related to the occurrence of PSD in the patients. SPECT technique was used to measure the rCBF values in the various brain regions of the patients with stroke. To analyze the correlation between the occurrence of PSD and rCBF in different brain regions, To explore the pathogenesis of PSD. [results] 1. There is no significant correlation between the nature of stroke and the occurrence of PSD. There is no statistical significance. 2. There is no significant correlation between different course of disease and PSDS score. There was no significant correlation between the degree of neurological impairment and post-stroke depression score in stroke patients (P < 0.05). There was no significant correlation between social support score and post-stroke depression score in stroke patients (P = 0.2440.05. 5). There was a significant correlation between the regional cerebral blood flow in the lateral basal ganglia and the occurrence of PSD. There was a negative correlation between the Pearson correlation coefficient of P0.0140.05 and Pearson, and there was no significant correlation between the changes of cerebral blood flow in other parts and the occurrence of PSD. [conclusion] 1.The nature of stroke in the patients. There was no significant correlation between the duration of the disease, the degree of neurological impairment, the degree of social support and the occurrence of PSD. 2. The occurrence of PSD in the patients may be due to the decrease of blood flow in the right basal ganglia.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R749.4

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