《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (08): 757-758.

• 临床研究 • 上一篇    下一篇

老年脑卒中后抑郁42例临床分析

马莉; 赵新民; 戴智威   

  1. 浙江省宁波市保黎医院,浙江宁波市 315031
  • 收稿日期:2008-05-18 出版日期:2008-08-01 发布日期:2008-08-01

Clinical Analysis of 42 Elderly Patients with Post-stroke Depression

MA Li, ZHAO Xin-min, DAI Zhi-wei   

  1. Ningbo Baoli Hospital, Ningbo 315031, Zhejiang, China
  • Received:2008-05-18 Published:2008-08-01 Online:2008-08-01

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被引次数

13

摘要： 目的探讨老年脑卒中后抑郁(PSD)的发生率与性别、病变部位、脑卒中严重程度的关系及抗抑郁治疗情况。方法对112例脑卒中患者分别采用抑郁自评量表(SDS)和汉密尔顿抑郁量表(HAMD)进行评定,分析符合PSD诊断的42例患者的相关因素。结果老年PSD的发生率为37.5%,其中以轻-中度PSD为主,占90.5%(P<0.01);女性PSD的发生率明显高于男性(P<0.01);基底节病变的PSD发生率明显高于大脑皮质或小脑、脑干病变(P<0.01),但不同大脑侧别病变的PSD发生率差异无显著性意义(P>0.05);多发病灶的PSD发生率高于单发病灶(P<0.05);重度神经功能缺损的PSD发生率高于中度神经功能缺损(P<0.05)和轻度神经功能缺损(P<0.01);在治疗原发病的基础上采用心理治疗和抗抑郁药物治疗后,患者的HAMD评分明显下降(P<0.01)。结论老年脑卒中患者PSD的发生率高,以轻、中度PSD为主;女性较男性易患PSD;基底节病变PSD发生率较高,PSD的发生与病变的大脑侧别无关;病灶损害愈多,神经功能缺损愈严重,PSD发病率愈高;治疗原发病的同时,配合心理治疗和抗抑郁治疗有明显疗效。

关键词: 抑郁症, 脑卒中, 老年人

Abstract: Objective To investigate the relationships between incidence of post-stroke depression(PSD)and sex,lesion sites and stroke severity,as well as the treatment of anti-depression in elderly patients.Methods 112 stroke patients were assessed by Self-rating Depression Scale(SDS)and Hamilton Depression Scale(HAMD)to evaluate the severity of depression,and the related features were analyzed in 42 diagnosed PSD patients.Results The incidence of PSD was 37.5% in elderly patients,90.5% of which were mild-and moderate-depression(P<0.01).The incidence of PSD was significantly different between genders(P<0.01).PSD incidence in patients with basal ganglia lesion was significantly different compared to that with lesions of cerebral cortex,cerebellum or brainstem(P<0.01).PSD incidence in patients with left cerebral hemisphere lesion was similar with that in those with right or both sides of cerebral hemisphere lesions(P>0.05).PSD incidence was different between patients with mono-and poly-lesions.PSD incidence in patients with severe degree of neurological dysfunction was significantly different compared to that with moderate or mild degrees of neurological dysfunction(P<0.05,P<0.01).Based on the treatment of stroke,the HAMD scores decreased significantly after mind-cure and anti-depression medication treatments(P<0.01).Conclusion PSD incidence is high in elderly patients,and most of PSD are mild and moderate.Females are susceptibility with PSD than males.PSD incidence is higher in patients with basal ganglia lesion,but is not correlated with the infracted area.The more lesions in cerebral,and the severer degree of neurological dysfunction,the PSD incidence is higher.The treatments of mind-cure and anti-depression medications based on the treatment of stroke are safe and effective for PSD patients.

Key words: depression, stroke, elderly