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1、首次脑卒中后抑郁临床研究[摘耍]日的:探讨首次脑卒中后抑郁(post-strokedepression,PSD)的发生率及其危险因素,为卒中后抑郁的干预及方法提供依据。方法:连续入组的发病72h内入院的急性脑卒中患者127例,根据入院14d内汉密尔顿抑郁量表(17项)评分分为PSD组和非PSD组,分析并比较PSD与性别、婚姻状况、年龄、文化程度、卒屮类型、病灶部位、高血压、糖尿病、冠心病、吸烟、饮酒、体质量指数(BMI)、卒中家族史、颈动脉斑块、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)和简易精神状态检查(MMSE)量表评分等临床因索的关系。结果:本组
2、PSD发生率为36.2%(46例)。PSD组男性、脑梗死比率、伴高血压病比率、伴糖尿病比率及伴冠心病比率、入院时BI明显低于非PSD组(P<0.05或0.01)o结论:脑卒中急性期患者PSD的发生率较高,男性、脑梗死、合并高血压、糖尿病、冠心病和入院时BI是PSD的独立危险因素。[关键词]卒中后抑郁;发生率;危险因素;干预[中图分类号]R749.4[文献标识码]A[文章编号11674-4721(2011)04(a)-042-02Clinicalstudyonpost-strokedepressionSONGMei,YUMinDepartmentofNeurology,SecondW
3、ard,theThirdPeople,sHospitalofDalianCity,LiaoningProvince,Dalian116031,China[Abstract]Objective:Toinvestigatetheincidenceanditsriskfactorsofpost-strokedepress!on(PSD)incerebralstrokepatientsatacutestage・Methods:127strokepatientsconsecutiveadmittedtohospitalwithin72honsetweredividedintoPSDgroup
4、andnon-PSDgroupaccordingtothescoresof17-itemHamiltonDepressionRatingscale(HAMD)inthe14dafteradmission.TherelationshipbetweenPSDandclinicalfactorsincludingsex,maritaistatus,age,education,stroketype,lesionlocation,hypertension,diabetes,coronaryarterydisease,smoking,drinking,BMI,familyhistoryofst
5、roke,scoreofNationalInstitutesofHea1thStrokeScale(NIHSS),BarthelIndex(BI),andscoreofminimentalstatueexamination(MMSE)wereanalyzed.Results:ThePSDincidenceinthisgroupwas36.2%(46cases)・InPSDgroup,manwereeasiertohypertension,theinfarctvolumeandscoresofBIonadmissionweresignificantlyhigher,BIandscor
6、eofMMSEonadmissionweresignificantlylowerthannon-PSDgroup(P<0.05or0.01).Conclusion:TheincidenceofPSDinpatientswithcerebalstrokeatacutestageishigh.Thecerebralinfarction,hypertensionandBIonadmissionaretheindependentriskfactorsofPSD.[Keywords]Post-strokedepression;Incidenee;Riskfactor;Intervention
7、随着卒屮发病率的居高不下,急性脑卒屮后抑郁亦逐渐被我们所认识。卒中后抑郁(PSD)是脑卒中常见并发症,增加病死率,降低患者的生活质量,严重影响患者的预后,并增添家庭社会的负担。为更全面了解PSD的发病机制和有效治疗PSD提供机会,笔者对本科2009年1〜12月收治的首次脑卒中患者127例,其中出现PSD者46例的临床资料进行分析,现将结果报道如门1资料与方法1.1一般资料选取2009年P12月本科住院患者127例首次脑卒中患者,男性75例,女性52例,平均年龄(65土