本文關鍵詞： 腦卒中 卒中后抑郁 相關因素 局部腦血流量 發(fā)病機制　出處：《昆明醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：[目的]通過評價腦卒中患者的卒中性質(zhì)、病程時間、神經(jīng)功能缺損程度和社會支持度,分析影響患者卒中后抑郁(post-stroke depression,PSD)發(fā)生的相關因素,應用單光子發(fā)射計算機斷層掃描術(single photon emission computed tomography,SPECT)測量卒中患者的局部腦血流量(regional cerebral blood flow,rCBF),探索PSD的發(fā)病機制。[方法]隨機收集48例腦卒中患者的卒中性質(zhì)和病程時間信息,并按病程時間(1月、1-2月、2-3月、3月)將病人分為4組,應用美國國立衛(wèi)生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)評估患者的神經(jīng)功能缺損程度,社會支持度量表(Social Support Rating Scale,SSRS)評價患者的社會支持度,以及腦卒中抑郁量表(Post-Stroke Depression Scale,PSDS)評定患者的抑郁程度,分析患者PSD發(fā)生的相關因素。應用SPECT技術檢測腦卒中患者各腦區(qū)的rCBF值,分析PSD發(fā)生與不同腦區(qū)rCBF之間的相關性,探索PSD的發(fā)病機制。[結果]1.卒中性質(zhì)與PSD的發(fā)生無明顯相關性,P=0.5720.05,無統(tǒng)計學意義。2.不同病程時間與PSDS評分之間無顯著相關性(P=0.4100.05)。組別之間患者的抑郁情況也無顯著性差異,P均0.05,無統(tǒng)計學意義。3.腦卒中患者的神經(jīng)功能缺損程度與卒中后抑郁評分無顯著相關性(P=0.1140.05)。4.腦卒中患者的社會支持度評分與卒中后抑郁評分無明顯相關性(P=0.2440.05)。5.右側基底節(jié)區(qū)局部腦血流值與PSD的發(fā)生具有顯著相關性(P=0.0140.05),Pearson相關系數(shù)=-0.424,呈負性相關。其余部位腦血流量的改變與PSD的發(fā)生無顯著相關性(P值均0.05)。[結論]1.患者的卒中性質(zhì)、病程時間、神經(jīng)功能缺損程度、社會支持度與PSD的發(fā)生無明顯相關性。2.患者PSD的發(fā)生可能是由于右側基底節(jié)區(qū)血流量的下降所致。
[Abstract]:[objective] to evaluate the nature of stroke, duration of stroke, degree of neurological impairment and degree of social support in stroke patients, and to analyze the related factors affecting post-stroke depression (PSD). Single photon emission computed tomographygraphy (SPECT) was used to measure regional cerebral blood flow rCBFN in patients with stroke, and to explore the pathogenesis of PSD. [methods] 48 patients with stroke were randomly collected for information on the nature and duration of stroke. The patients were divided into 4 groups according to the duration of the disease course (January, January-February to Jan.2-3, March). The National Institute of Health Stroke scale (NIHSS) was used to evaluate the degree of neurological impairment in the patients. The Social Support Rating scale (SSRS) was used to evaluate the degree of social support, and the Post-Stroke Depression scale (PSDSs) to assess the degree of depression, and to analyze the factors related to the occurrence of PSD in the patients. SPECT technique was used to measure the rCBF values in the various brain regions of the patients with stroke. To analyze the correlation between the occurrence of PSD and rCBF in different brain regions, To explore the pathogenesis of PSD. [results] 1. There is no significant correlation between the nature of stroke and the occurrence of PSD. There is no statistical significance. 2. There is no significant correlation between different course of disease and PSDS score. There was no significant correlation between the degree of neurological impairment and post-stroke depression score in stroke patients (P < 0.05). There was no significant correlation between social support score and post-stroke depression score in stroke patients (P = 0.2440.05. 5). There was a significant correlation between the regional cerebral blood flow in the lateral basal ganglia and the occurrence of PSD. There was a negative correlation between the Pearson correlation coefficient of P0.0140.05 and Pearson, and there was no significant correlation between the changes of cerebral blood flow in other parts and the occurrence of PSD. [conclusion] 1.The nature of stroke in the patients. There was no significant correlation between the duration of the disease, the degree of neurological impairment, the degree of social support and the occurrence of PSD. 2. The occurrence of PSD in the patients may be due to the decrease of blood flow in the right basal ganglia.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3;R749.4

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本文編號：1531996