急性缺血性卒中后抑郁的相关危险因素分析

发布时间：2018-04-26 12:30

本文选题：缺血性脑卒中 + 卒中后抑郁　；参考：《临床神经病学杂志》2016年06期

【摘要】：目的探讨急性缺血性卒中后抑郁(PSD)的发生率及其相关危险因素。方法 185例经CT或MRI证实的急性缺血性卒中患者根据精神障碍诊断和统计手册第5版(DSM-V)标准和24项Hamilton抑郁量表(HAMD)评分分为PSD组和non-PSD组;分析PSD社会人口学资料、血管危险因素、相关生化指标、NIHSS、Barthel指数(BI)、MMSE等相关因素对PSD的影响。结果本组PSD发生率为40.54%(75例),主要以轻、中度抑郁为主;与non-PSD组比较,PSD组患者糖尿病发生率高(P=0.044),神经功能缺损程度重、日常生活活动能力差(P=0.000,P=0.001),MMSE评分降低(P=0.000),而超敏C-反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)水平升高(P=0.000,P=0.006);其中BI、MMSE评分与HAMD评分呈负相关(均P0.05),而NIHSS评分、hs-CRP和Hcy与HAMD评分呈正相关(均P0.05);Logistic回归分析提示,低MMSE评分、高NIHSS评分及高hs-CRP和Hcy水平可能是急性缺血性PSD的独立危险因素。结论 PSD主要以轻、中度抑郁为主;PSD与糖尿病病史、认知功能障碍、神经功能缺损程度、hs-CRP和Hcy水平密切相关。
[Abstract]:Objective to investigate the incidence and risk factors of PSDs after acute ischemic stroke. Methods 185 patients with acute ischemic stroke confirmed by CT or MRI were divided into PSD group and non-PSD group according to DSM-V criteria and 24 items of Hamilton depression scale according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The influence of related factors on PSD such as NIHSS Barthel Index (BI) and MMSE. Results the incidence of PSD in this group was 40.54 and 75 cases, mainly mild and moderate depression, compared with non-PSD group, the incidence of diabetes was higher than that of non-PSD group, and the degree of nerve function defect was serious. The activity of daily living (ADL) was poor and the score of MMSE was lower than that of P0. 000, while the levels of high sensitive C- reactive protein (hs-CRP) and homocysteine (Hcyn) were higher than that of P0. 000mMSE (all P 0. 05), and the NIHSS scores were positively correlated with HAMD (all P 0. 05) (P < 0. 05), but the scores of hs-CRP and Hcy were positively correlated with HAMD (all of them were negatively correlated with the scores of HAMD) (P < 0. 05), but the scores of hs-CRP and Hcy were positively correlated with the scores of HAMD (P < 0. 05). P 0.05 logistic regression analysis showed that, Low MMSE score, high NIHSS score and high hs-CRP and Hcy levels may be independent risk factors for acute ischemic PSD. Conclusion PSD mainly consists of mild and moderate depression, which is closely related to diabetic history, cognitive impairment, degree of neurological impairment and Hcy levels.
【作者单位】：右江民族医学院附属医院神经内科;右江民族医学院附属医院肾内科;右江民族医学院附属医院影像科;
【基金】：国家自然科学基金(81169146)
【分类号】：R749.13

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