卒中后抑郁患者的临床异质性研究

发布时间：2018-10-05 09:49

【摘要】：目的探讨卒中后抑郁(PSD)患者的临床异质性。方法选取2015年10月—2016年5月华北理工大学附属医院收治的脑卒中患者474例,收集其一般临床资料并采用汉密尔顿抑郁量表(HAMD)评估其抑郁状况。结果 474例患者中,PSD患者169例(35.6%)。轻中度PSD患者[133例(78.7%)]症状严重系数较高的2项因子为睡眠障碍(0.77)和绝望感(0.43),症状严重系数较低的2项因子为日夜变化(0.06)和体质量(0.20)。重度PSD患者[36例(21.3%)]症状严重系数较高的2项因子为睡眠障碍(0.81)和焦虑/躯体化(0.64),症状严重系数较低的2项因子为日夜变化(0.24)和认知障碍(0.37)。不同性别PSD患者焦虑/躯体化、绝望感因子均分比较,差异有统计学意义(P0.05);不同性别PSD患者体质量、认知障碍、日夜变化、迟缓、睡眠障碍因子均分及HAMD总分比较,差异无统计学意义(P0.05)。不同年龄PSD患者焦虑/躯体化、认知障碍、日夜变化、迟缓、睡眠障碍、绝望感因子均分及HAMD总分比较,差异有统计学意义(P0.05);不同年龄PSD患者体质量因子均分比较,差异无统计学意义(P0.05)。结论不同严重程度、性别及年龄的PSD患者抑郁可能存在临床异质性,应制定个性化治疗方案和选用合理的药物,提高治疗效果和改善患者预后。
[Abstract]:Objective to investigate the clinical heterogeneity of (PSD) patients with post-stroke depression. Methods from October 2015 to May 2016, 474 stroke patients treated in affiliated Hospital of Huabei University of Science and Technology were selected and their general clinical data were collected and their depression status was evaluated by Hamilton Depression scale (HAMD). Results there were 169 (35.6%) patients with PSD in 474 patients. The two factors with higher symptom severity coefficient were sleep disorder (0.77) and hopelessness (0.43) in mild and moderate PSD patients. The two factors with lower symptom severity coefficient were day and night change (0.06) and body mass (0.20). The two factors with higher symptom severity coefficient were sleep disorder (0.81) and anxiety / somatization (0.64) in patients with severe PSD [36 cases (21.3%)], and the two factors with lower symptom severity coefficient were changes of day and night (0.24) and cognitive impairment (0.37). The mean scores of anxiety / somatization and hopelessness in PSD patients of different sexes were significantly different (P0.05), and the mean scores of body mass, cognitive impairment, day and night changes, retardation, sleep disturbance factors and total HAMD scores of PSD patients of different genders were compared. The difference was not statistically significant (P0.05). There were significant differences in anxiety / somatization, cognitive impairment, day and night change, retardation, sleep disorder, despair factor mean score and total HAMD score in PSD patients of different ages (P0.05); The difference was not statistically significant (P0.05). Conclusion there may be clinical heterogeneity in depression in patients with PSD with different severity, sex and age. It is necessary to make individualized treatment and select reasonable drugs to improve the therapeutic effect and improve the prognosis of the patients.
【作者单位】：华北理工大学精神卫生研究所;华北理工大学研究生院;天津医科大学肿瘤医院人事处;华北理工大学附属开滦精神卫生中心;唐山职业技术学院临床医学系;
【基金】：2016年度河北省医学科学研究重点课题计划立项项目(20160218)
【分类号】：R749.13

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