本文選題：卒中后抑郁 + 相關(guān)因素��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]應(yīng)用神經(jīng)影像技術(shù)判斷卒中患者的卒中性質(zhì)和病程時(shí)間,結(jié)合量表評(píng)定患者的神經(jīng)功能功能缺損程度、社會(huì)支持度和卒中后抑郁程度,分析腦卒中后抑郁發(fā)生的相關(guān)因素,并進(jìn)一步檢測(cè)腦卒中患者的神經(jīng)遞質(zhì)和免疫因子,探索腦卒中后抑郁發(fā)病的機(jī)制。[方法]隨機(jī)收集腦卒中患者45例,根據(jù)患者的影像學(xué)數(shù)據(jù)判斷其卒中性質(zhì)(缺血性腦卒中或者出血性腦卒中),明確腦卒中的病程時(shí)間,并分別應(yīng)用美國(guó)國(guó)立衛(wèi)生研究院卒中量表(national institute of health stroke scale,NIHSS)評(píng)定患者的神經(jīng)功能缺損程度、社會(huì)支持評(píng)定量表(social support rating scale,SSRS)評(píng)價(jià)其獲得的社會(huì)支持度以及卒中后抑郁量表(post-stroke depression scale,PSDS)評(píng)估其抑郁程度,分析PSD發(fā)生的相關(guān)因素。采集腦卒中患者的外周血,應(yīng)用安捷倫液相色譜質(zhì)譜聯(lián)用儀檢測(cè)血清中的神經(jīng)遞質(zhì)水平,包括5-HT、多巴胺、去甲腎上腺素和腎上腺素;同時(shí)應(yīng)用ELISA法檢測(cè)白細(xì)胞介素(IL-1β、IL-2、IL-6)和腫瘤壞死因子(TNF-α);并同時(shí)分析患者的5-HTTLPR;探索PSD的發(fā)病機(jī)制。[結(jié)果]1、PSDS與患者的卒中類(lèi)型無(wú)顯著相關(guān)性(P0.05)。2、PSDS與患者的卒中病程無(wú)顯著相關(guān)性(P0.05);但卒中病程顯著影響患者的神經(jīng)功能缺損程度,病程大于3個(gè)月的患者的神經(jīng)功能缺損程度最嚴(yán)重。3、PSDS與患者的神經(jīng)功能缺損程度呈顯著正相關(guān)(P0.05)。4、PSDS與患者的社會(huì)支持度無(wú)顯著相關(guān)性(P0.05),但表現(xiàn)為隨著社會(huì)支持度的增加,患者卒中后抑郁的發(fā)生有下降趨勢(shì)。5、PSDS與患者的5-HTTLPR無(wú)顯著相關(guān)性(P0.05);但5-HTTLPR對(duì)患者的神經(jīng)功能缺損程度有顯著性影響,SS基因型的患者神經(jīng)功能缺損程度最嚴(yán)重。6、PSDS與患者的細(xì)胞因子無(wú)顯著相關(guān)性。7、PSDS與患者的神經(jīng)遞質(zhì)無(wú)顯著相關(guān)性(P0.05),但隨著DA與5-HT水平的下降,患者的PSDS評(píng)分有上升的趨勢(shì)分?jǐn)?shù)的增加,E、NE有上升趨勢(shì),DA與5-HT有下降趨勢(shì),且5-HT下降趨勢(shì)尤為明顯。[結(jié)論]1、卒中后抑郁癥的發(fā)生與患者的卒中類(lèi)型、病程和社會(huì)支持度沒(méi)有顯著相關(guān)性,而是與其神經(jīng)功能缺損程度呈顯著正相關(guān)。2、卒中后抑郁癥的發(fā)生可能是由于患者的神經(jīng)遞質(zhì)水平下降所致。
[Abstract]:[objective] to judge the nature and duration of stroke by using neuroimaging technique, and to evaluate the degree of neurological function deficit, social support and post-stroke depression with the scale. The related factors of post-stroke depression were analyzed and the neurotransmitters and immune factors of stroke patients were detected to explore the mechanism of post-stroke depression. [methods] Forty-five patients with stroke were randomly collected to determine the nature of stroke (ischemic stroke or hemorrhagic stroke) according to the imaging data of the patients, and to determine the duration of stroke. The national institute of health stroke scale NIHSS was used to assess the degree of neurological impairment in the patients. Social support rating scale (SSRS) was used to evaluate the degree of social support and post-stroke depression scale (PSDSs) to evaluate the degree of depression, and to analyze the factors related to the occurrence of PSD. The peripheral blood samples of stroke patients were collected and the levels of neurotransmitters, including 5-HT, dopamine, norepinephrine and epinephrine, were detected by Agilent liquid chromatography-mass spectrometry. At the same time, ELISA method was used to detect interleukin-1 尾 interleukin-2 (IL-6) and tumor necrosis factor TNF- 偽 (TNF- 偽), and to analyze 5-HTTLPRs in order to explore the pathogenesis of PSD. [results] 1 there was no significant correlation between PSDS and stroke type. There was no significant correlation between P0.05 PSDS and the course of stroke, but the severity of neurological impairment was significantly affected by the course of stroke. There was a significant positive correlation between the degree of nerve function defect and the degree of nerve function defect in patients whose course of disease was longer than 3 months. There was no significant correlation between P0.05 PSDS and social support degree of patients, but it showed that with the increase of social support degree, there was no significant correlation between P0.05 and P0.05, but with the increase of social support, there was no significant correlation between the degree of PSDS and the degree of social support. There was no significant correlation between PSDs and 5-HTTLPR in patients with post-stroke depression, but 5-HTTLPR had a significant effect on the degree of neurological function defect in patients with SS genotype. There was no significant correlation between PSDs and neurotransmitters, but with the decrease of DA and 5-HT levels, there was no significant correlation between PSDs and neurotransmitters. The PSDS scores of the patients increased with the increasing trend of scores. There was an increasing trend of DA and 5-HT in the patients, especially in the 5-HT. [conclusion] 1. There was no significant correlation between the occurrence of post-stroke depression and the type of stroke, course of disease and degree of social support. However, there was a significant positive correlation between the degree of neurologic impairment and poststroke depression, which may be due to the decrease of neurotransmitter level in patients with stroke.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R743.3;R749.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳德鵬;;氟西汀改善腦卒中后抑郁及神經(jīng)功能缺損患者的臨床研究[J];中國(guó)當(dāng)代醫(yī)藥;2016年22期

2 徐慧;王萬(wàn)銘;;卒中后抑郁治療進(jìn)展[J];交通醫(yī)學(xué);2016年03期

3 魯曉波;趙勇;陳紅玉;;抑郁癥發(fā)病與血脂水平的相關(guān)性探討[J];貴州醫(yī)藥;2016年06期

4 王慧玲;黃朝云;;腦卒中后抑郁合并認(rèn)知損害的磁共振擴(kuò)散張量成像研究[J];卒中與神經(jīng)疾病;2016年03期

5 周敏亞;吳李秀;;針灸治療中風(fēng)后抑郁癥臨床療效及其安全性評(píng)價(jià)[J];中華中醫(yī)藥學(xué)刊;2016年02期

6 王國(guó)清;趙文靜;賈煒;吳俊梅;姚娟風(fēng);;卒中后抑郁臨床診斷及治療[J];環(huán)球中醫(yī)藥;2015年S1期

7 趙宏偉;李寶全;張曉明;趙淑霞;李暉;;早期不同CT值與卒中后抑郁指數(shù)及其生活質(zhì)量的關(guān)系[J];中國(guó)醫(yī)藥指南;2015年22期

8 許孝南;吳軍;陳旭輝;葉辰飛;黃正義;陶永軍;;卒中后抑郁的擴(kuò)散張量成像研究進(jìn)展[J];中國(guó)腦血管病雜志;2015年06期

9 楊海洪;;卒中后抑郁與卒中部位的關(guān)系[J];河北醫(yī)科大學(xué)學(xué)報(bào);2015年06期

10 陳菲菲;成利霞;;腦卒中后抑郁患者的臨床分析[J];現(xiàn)代診斷與治療;2014年17期

，

本文編號(hào)：1841546