本文選題：急性腦卒中 + 抑郁�。� 參考：《華中科技大學》2013年碩士論文

【摘要】：目的：研究急性腦卒中患者抑郁的發(fā)生情況以及與卒中后抑郁相關危險因素。 方法：按照納入標準及排除標準前瞻性納入了86例來武漢協(xié)和醫(yī)院神經(jīng)內(nèi)科入院的急性腦卒中患者。調(diào)查他們的所有的臨床資料，填寫病例登記本，采集外周血并低溫保存待用。患者的一般資料包括性別、年齡、居住地、職業(yè)、卒中類型、卒中次數(shù)、習慣（吸煙、飲酒）、卒中家族史、是否患有高血壓、糖尿病等其他疾病等，搜集并記錄患者血樣檢測的各項指標包括膽固醇、甘油三酯、LDL-C、HDL-C、CRP、血沉，并采集患者的血液用ELISA法檢測IL-6、TNF-α血清濃度。對每位患者腦卒中在發(fā)病兩周內(nèi)進行PHQ-9、簡易智能狀態(tài)檢查表、NIHSS評分，根據(jù)PHQ-9評分把患者分為急性腦卒中伴抑郁組和急性腦卒中無抑郁兩組。根據(jù)單因素分析方法，確定急性卒中伴發(fā)抑郁的危險因素。 結(jié)果：86例腦卒中患者平均年齡為53.02±12.68歲，，急性腦卒中后2周的PHQ-9評分的平均值為4.49±4.46（變化范圍為：0-17），腦卒中后2周內(nèi)抑郁癥狀總的發(fā)生率為34.88%。單因素分析的結(jié)果顯示：性格內(nèi)向、高濃度的TNF-α、高血壓、糖尿病是急性卒中后2周內(nèi)伴發(fā)抑郁的危險因素。TNF-α可以做為預測急性腦卒中后抑郁的獨立指標，當患者血清TNF-α濃度大于4.35pg/ml時，血清TNF-α濃度越高，腦卒中患者出現(xiàn)抑郁的可能性越大。本此研究中未發(fā)現(xiàn)性別、年齡、受教育程度、卒中類型、卒中家族史、其他合并癥、居住地、職業(yè)、血脂水平、CRP、IL-6、MMSE評分與卒中后抑郁的發(fā)生相關。 結(jié)論：性格內(nèi)向、高的NIHSS評分、高濃度的TNF-α、高血沉、高血壓、糖尿病是卒中患者在發(fā)病2周內(nèi)伴發(fā)抑郁的高危因素。
[Abstract]:Objective: to study the incidence of depression in patients with acute stroke and the risk factors associated with post-stroke depression.Methods: 86 patients with acute stroke admitted to Department of Neurology Wuhan Union Hospital were included prospectively according to inclusion criteria and exclusion criteria.Survey all their clinical data, fill in case register, collect peripheral blood and cryopreservation for use.The general data included sex, age, place of residence, occupation, type of stroke, number of strokes, habits (smoking, drinking alcohol, family history of stroke, whether or not you have hypertension, diabetes, etc.)Blood samples were collected and recorded, including cholesterol, triglyceride (LDL-C), HDL-CU (CRP), erythrocyte sedimentation rate (ESR), and serum levels of IL-6 TNF- 偽 were detected by ELISA method.The patients were divided into acute stroke with depression group and acute stroke without depression group according to PHQ-9 score.According to univariate analysis, the risk factors of depression in acute stroke were determined.Results the average age of 86 stroke patients was 53.02 鹵12.68 years old. The average PHQ-9 score of 2 weeks after acute stroke was 4.49 鹵4.46 (range: 0-17). The total incidence of depression within 2 weeks after stroke was 34.88.Univariate analysis showed that introversion, high concentration of TNF- 偽, hypertension and diabetes were risk factors of depression within 2 weeks after acute stroke. TNF- 偽 could be used as an independent index to predict depression after acute stroke.When the concentration of TNF- 偽 was higher than that of 4.35pg/ml, the higher the concentration of TNF- 偽, the greater the likelihood of depression in stroke patients.Gender, age, education, type of stroke, family history of stroke, other complications, residence, occupation, and blood lipid level were not associated with poststroke depression.Conclusion: introversion, high NIHSS score, high concentration of TNF- 偽, high ESR, hypertension and diabetes are high risk factors for depression in stroke patients within 2 weeks.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R743.3

【參考文獻】

相關期刊論文 前1條

1 王剛,崔利華,陳立嘉,張皓,楊明明,藍青;腦卒中后抑郁癥狀的發(fā)生率及相關因素的研究[J];中國康復理論與實踐;2000年04期

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