张莹,刘琴,杨青松

• 1:河南商丘市第一人民医院神经内科一病区

摘要(Abstract)：

目的研究急性脑卒中患者中认知功能障碍对远期产生抑郁症状(DS)的预测价值。方法根据入选排除标准选择143例脑卒中后前3周的病人,选择预测变量为早期认知功能、人口基性特征、血管危险因素、病变部位、抑郁症状、神经功能缺损及日常生活能力,因变量为入组后6～10个月后远期抑郁症状(蒙哥马利抑郁量表评分>7分)进行多元Logistic回归分析。结果早期认知功能障碍、早期抑郁症状、女性、糖尿病和既往短暂性脑缺血发作(TIA)病史是远期抑郁症状的独立危险因素。对于几乎所有认知障碍患者,单侧忽视是卒中后6个月抑郁症状最重要的危险因素。结论脑卒中后认知功能障碍和血管危险因素是远期抑郁症状的重要预测因子。

关键词(KeyWords)： 脑卒中;抑郁症状;认知功能障碍;Logistic回归分析

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张莹,刘琴,杨青松

参考文献(References)：

• [1]Williams LS,Ghose SS,Swindle RW.Depression and othermental health diagnoses increase mortality risk after ischemicstroke[J].Am J Psychiatry,2009,161:1 090-1 095.
• [2]Sturm JW,Donnan GA,Dewey HM,et al.Quality of life af-ter stroke:the North East Melbourne Stroke Incidence Study(NEMESIS)[J].Stroke,2004,35:2 340-2 345.
• [3]Nys GMS,van Zandvoort MJE,van der Worp HB,et al.Ear-ly depressive symptoms after stroke:neuropsychological corre-lates and lesion characteristics[J].J Neurol Sci,2005,228:27-33.
• [4]Verdelho A,Henon H,Lebert F,et al.Depressive symptomsafter stroke and relationship with dementia:a three-year fol-low-up study[J].Neurology,2004,62:905-911.
• [5]Aben I,Denollet J,Lousberg R,et al.Personality and vulner-ability to depression in stroke patients:a 1-year prospectivefollow-up study[J].Stroke,2010,33:2 391-2 395.
• [6]Rampello L,Chiechio S,Nicoletti G,et al.Prediction of theresponse to citalopram and reboxetine in post-stroke depressedpatients[J].Psychopharmacology(Berl),2004,173:73-78.
• [7]Nys GMS,van Zandvoort MJE,de Kort PLM,et al.Theprognostic value of domainspecific cognitive abilities in acutefirst-ever stroke[J].Neurology,2005,64:821-827.
• [8]DeGraba TJ,Hallenbeck JM,Pettigrew KD,et al.Progres-sion in acute stroke:value of the initial NIH stroke scale scoreon patient stratification in future trials[J].Stroke,1999,30:1208-1 212.
• [9]Weimar C,Ziegler A,Konig IR,et al.Predicting functionaloutcome and survival after acute ischemic stroke[J].J Neurol,2002,249:888-895.
• [10]Shimoda K,Robinson RG.The relationship between posts-troke depression and lesion location in long-term follow-up[J].Biol Psychiatry,2006,45:187-192.
• [11]Biran I,Chatterjee A.Depression with anosognosia followinga left subcortical stroke[J].Clin Neurol Neurosurg,2003,105:99-101.
• [12]Spalletta G,Guida G,De Angelis D,et al.Predictors of cog-nitive level and depression severity are different in patientswith left and right hemispheric stroke within the first year ofillness[J].J Neurol,2009,249:1 541-1 551.
• [13]Jacobson AM,Samson JA,Weinger K,et al.Diabetes,thebrain,and behavior:is there a biological mechanism underly-ing the association between diabetes and depression?[J].IntRev Neurobiol,2002,51:455-479.