本文關(guān)鍵詞： 急性期腦卒中 急性期腦梗死后抑郁 抑郁程度 發(fā)病因素 腦電圖　出處：《深圳大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：腦梗死后抑郁(Post-cerebral-infarction Depression,PCID)為腦梗死后的常見精神類并發(fā)癥。其臨床表現(xiàn)為情緒消沉、興趣減退,意識(shí)、失語和智能障礙等,醫(yī)生無法對(duì)其詳細(xì)問診,加上缺乏特異性的檢查手段,增加了PCID的誤診率和漏診率。因此探究一種客觀性、特異性水平高的PCID診斷方法,顯得尤為重要。目的⑴采用HAMD量表測(cè)評(píng)以探討影響急性期腦梗死后抑郁狀態(tài)的相關(guān)因素。⑵通過分析急性期PCID患者的異常腦電活動(dòng),尋求診斷急性期PCID疾病的客觀依據(jù)。⑶探討急性期PCID患者的抑郁程度和病灶部位、腦電圖之間的關(guān)系。⑷明確急性期PCID患者的異常腦電活動(dòng)與HAMD量表測(cè)評(píng)結(jié)果一致,探討急性期PCID的發(fā)病機(jī)制與生物-社會(huì)-心理因素相互作用的關(guān)系。方法選取深圳市第二人民醫(yī)院神經(jīng)內(nèi)科就診的急性期腦梗死患者,根據(jù)年齡和HAMD量表測(cè)評(píng)結(jié)果進(jìn)行分組,并收集患者的電子病歷�；颊呷朐�7天內(nèi)進(jìn)行腦電圖檢查,醫(yī)師分析其異常腦電活動(dòng),用SPSS統(tǒng)計(jì)軟件分析收集的數(shù)據(jù)。結(jié)果1.本文研究的急性期腦梗死患者321例,急性期腦梗死后無抑郁患者88例,急性期腦梗死后抑郁患者233例,急性期PCID的發(fā)病率為72.6%。2.急性期PCID發(fā)生的概率隨著患者的教育程度升高而增加(P0.05),相對(duì)于教育程度較低的患者,教育程度較高的患者易發(fā)生急性期PCID;而急性期PCID與患者的年齡、性別無明顯關(guān)系(P0.05)。3.高血壓史與急性期PCID的發(fā)生有明顯相關(guān)性(P0.05)。而急性期PCID與糖尿病史、飲酒史、吸煙史、合并癥無明顯相關(guān)性(P0.05)。4.病灶部位(基底節(jié)、放射冠)、病灶個(gè)數(shù)≥2,易發(fā)生急性期PCID(P0.05)。而其它病灶部位(額葉、顳葉、頂葉、枕葉)、腦梗死次數(shù)與急性期PCID無明顯相關(guān)性(P0.05)。5.急性期PCID患者的腦電圖易呈現(xiàn)低振幅α波和θ波(P0.05)。而急性期PCID患者腦電圖中出現(xiàn)β波和δ波與急性期PCID的發(fā)生無明顯相關(guān)性,其分布差異無統(tǒng)計(jì)學(xué)意義(P0.05)。6.急性期PCID患者的抑郁程度與病灶部位、病灶個(gè)數(shù)、腦梗死次數(shù)、異常腦電活動(dòng)無明顯相關(guān)性,其分布差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論急性期腦梗死患者的教育程度越高、高血壓史、病灶部位(基底節(jié)和放射冠)、多病灶與急性期PCID的發(fā)生相關(guān)性較大。急性期PCID患者的腦電圖易呈現(xiàn)低振幅α波和θ波腦電活動(dòng)。急性期腦梗死患者的腦電圖結(jié)果與HAMD量表測(cè)評(píng)的結(jié)果相一致,急性期PCID的發(fā)病機(jī)制由生物-社會(huì)-心理因素相互作用引起的。腦電圖可作為急性期PCID疾病的輔助診斷方法,為急性期PCID的治療提供新的評(píng)價(jià)、監(jiān)測(cè)手段。
[Abstract]:Post-cerebral-#en0# after cerebral infarction. PCID is a common mental complication after cerebral infarction. Its clinical manifestations are depression, decreased interest, consciousness, aphasia and mental disorders, etc. Combined with the lack of specific means of examination, the misdiagnosis rate and missed diagnosis rate of PCID are increased. Therefore, an objective and highly specific diagnostic method of PCID is explored. Objective 1 to investigate the related factors of depression after acute cerebral infarction by using HAMD scale. 2. To analyze abnormal EEG activity in patients with acute PCID. Objective basis for the diagnosis of acute PCID disease. 3 to explore the degree of depression and the location of lesion in patients with acute PCID. The relationship between electroencephalogram (EEG). 4 it is clear that the abnormal EEG activity of PCID patients in acute stage is consistent with the results of HAMD scale. To explore the relationship between the pathogenesis of acute PCID and the interaction of biological, social and psychological factors. Methods the patients with acute cerebral infarction in the Department of Neurology, second people's Hospital of Shenzhen City were selected. The patients were divided into groups according to their age and the results of HAMD scale, and their electronic medical records were collected. The patients were examined by EEG within 7 days of admission, and their abnormal EEG activity was analyzed by physicians. The data collected were analyzed by SPSS software. Results 1. 321 patients with acute cerebral infarction and 88 patients with no depression after acute cerebral infarction were studied in this paper. 2. The incidence of PCID in acute stage was 72.60.2.The probability of PCID in acute phase increased with the increase of education level (P 0.05). Compared with the patients with lower education level, the patients with higher education level were more likely to develop acute PCID; In acute stage, PCID was associated with the patient's age. There was no significant correlation between sex and history of hypertension and PCID in acute stage. However, PCID in acute stage was associated with history of diabetes mellitus, history of drinking alcohol, and history of smoking. There was no significant correlation between the lesions (basal ganglia, coronal radiosurgery, the number of lesions 鈮，

本文編號(hào)：1488149