脑卒中后抑郁症临床探讨
查德喜
摘要(Abstract):
目的对脑卒中后并发抑郁症的临床资料进行分析,探讨脑卒中后抑郁的发生率及相关致病因素。方法对181例明确诊断为脑卒中的住院患者,采用抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)、改良的爱丁堡斯堪的那维亚神经功能缺损评分表(MESSS)进行评定。结果脑卒中后抑郁的发生率45.9%。抑郁的发生与性别、年龄、神经功能缺损有显著相关性,与额叶、丘脑、左侧大脑半球有关(P<0.05),合并高血压、糖尿病、大动脉粥样硬化的卒中患者PSD发病率明显高于无危险因素患者(P<0.05)。结论脑卒中后抑郁发生率较高,其发生与多种因素相关。
关键词(KeyWords): 脑卒中;卒中后抑郁;相关因素;神经功能缺损
基金项目(Foundation):
作者(Author): 查德喜
参考文献(References):
- [1]吴江,贾建平,崔丽英.神经病学[M].北京:人民卫生出版社,2005:375-376.
- [2]周颖,李宗友,陆景红.中青年脑卒中后抑郁相关因素分析[J].蚌埠医学院学报,2007,32(5):126.
- [3]Tharwani HM,Yerramsetty P,Mannelli P,et al.Recent ad-vances in post-stroke depression[J].Curr Psychiatry Rep,2007,9(3):225-231.
- [4]吴宇浩,王少石.卒中后抑郁[J].国外医学脑血管病分册,2005,13(9):699-702.
- [5]李志彬.老年期脑卒中后抑郁与病灶关系[J].临床精神医学杂志,2004,14(1):23.
- [6]Gao Z,Lin QG,Jiang C.Study on the relative factions ofpoststroke depression in stroke acute phase[J].zhongguo lin-chuang kangfu(Clin J Clin Rehabil),2002,6(13):1 890-1 893.
- [7]Dafer RM,Rao M,Shareef A,et al.Poststroke depression[J].Top Stroke Rehabil,2008,15:13-21.
- [8]Vataja R,Leppavuori A,Pohjasvaara T,et al.Post-stroke de-pression and lesion location revisited[J].J Neuropsychiatry ClinNeurosci,2004,16:156-162.
- [9]Narushima K,Kosier JT,Robinson RG.A reappraisal of poststroke depression,intra-and inter-hemispheric lesion locationusing meta-analysis[J].J Neuropsychiatry Clin Neurosci,2003,15:422-430.
- [10]Nys GM,van Zandvoort MJ,van der Worp HB,et al.Earlydepresssive symptoms after stroke:neuropsychological corre-lates and lesion characteristics[J].J Neurol Sci,2005,228:27-33.
- [11]Starkstein SE,Mizrahi R,Power BD.Antidepressant therapyin post-stroke depression[J].Expert Opin Pharmacother,2008,9:1 291-1 298.
- [12]Starkstein SE,Manes F.Apathy and depression followingstroke[J].CNS Spectr,2000,5:43-50.
- [13]Brody AL,Saxena S,Mandelkem MA,et al.Brain metabolicchanges associated with symptom factor improvement in ma-jor depressive disorder[J].Biol Psychiatry,2001,50:171-178.
- [14]Kimura MShimoda K,Mizumura S,et al.Regional cerebralblood flow in vascular depression assessed by 123I-IMPSPECT[J].J Nippon Med Sch,2003,70:321-326.
- [15]王立伟,赵庆莲.血管性抑郁症临床特征的比较研究[J].中国神经精神疾病杂志,2000,26(3):176-178.
- [16]Pohjavaara T,Leppavuori A,Siifa I,et al.Frequency andclinical determinants of poststroke depression[J].Stroke,1998,29:2 311.
- [17]Anderson G,Vestergaard K,Ingeman-Nielson MW,et al.Riskfactors for depression after apoplexy[J].Ugeskr Laeger,1996,158(43):6 107-6 110.