本文選題：腦卒中后抑郁　切入點：發(fā)生率　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的1、前瞻性研究急性腦卒中患者卒中后抑郁發(fā)生率及其臨床特點;2、比較急性卒中后抑郁患者與急性卒中后非抑郁患者之間臨床資料、實驗室檢查、影像學檢查等相關因素的差異;3、利用Logistic回歸分析進一步了解急性腦卒中后抑郁的相關危險因素。方法采用前瞻性、觀察性臨床研究方法,連續(xù)入選2016年4月~2016年9月在寧夏醫(yī)科大學總醫(yī)院神經(jīng)內(nèi)科住院且符合診斷標準的急性腦卒中(發(fā)病7天內(nèi))的患者共97例,收集患者的一般資料,包括社會人口學調(diào)查、既往病史、實驗室指標,顱腦影像學檢查等。在患者發(fā)病后14d±2d對所有患者采用PHQ-9進行抑郁篩查,將其分成腦卒中后抑郁組和腦卒中后非抑郁組,并對其進行MMSE、NIHSS及ADL評分,比較兩組間一般臨床資料、實驗室檢驗、影像學檢查等相關因素的差異。結(jié)果1.一般資料:共入選97例患者,31例患者發(fā)生抑郁,男:女=15:16,輕度抑郁29例,中度抑郁2例,無抑郁66例,抑郁發(fā)生率31.96%(31/97)。兩組間年齡、婚姻狀況、受教育程度、職業(yè)、超重與肥胖、體質(zhì)指數(shù)、居住狀況、經(jīng)濟收入、醫(yī)保類型、獨居、血型、既往史、吸煙、飲酒、過敏史、血脂水平、血糖水平無顯著相關(p0.05)�；刈寤颊叩腜SD發(fā)生率高于漢族患者(35.71%VS 31.33%),兩組經(jīng)統(tǒng)計學發(fā)現(xiàn)無差異性(p=0.9870.05);PSD組女性16例,發(fā)生率44.44%(16/36),男性15例,發(fā)生率24.59%(15/61),兩組有統(tǒng)計學意義(p=0.0430.05);2個及以上合并癥的患者PSD的發(fā)生率高于1個合并癥的患者,兩組差別有統(tǒng)計學意義(p=0.0030.05)。2.腦卒中部位:多次卒中患者的PSD的發(fā)生率高于首次卒中患者,但無統(tǒng)計學意義(47.37%VS 28.21%,p=0.1080.05);兩組間卒中類型(p=0.369)、病灶數(shù)量(p=0.657)、病灶梗死面積(p=1.000)、額葉(p=0.581)、頂葉(p=0.743)、顳葉(p=1.000)、枕葉(p=0.455)、丘腦(p=1.000)、基底節(jié)區(qū)(p=0.546)、側(cè)腦室旁(p=0.735)、小腦(p=1.000)無明顯差異性(p0.05),但左側(cè)大腦半球病變有明顯相關性(X2=5.659,p=0.0170.05)。3.發(fā)病14d±2d行NIHSS評分PSD組明顯高于非PSD組,ADL、MMSE評分PSD組均低于非PSD組,具有顯著統(tǒng)計學意義(p0.05)。4、經(jīng)Logistic回歸分析顯示PSD與合并癥個數(shù)、NIHSS評分密切相關。結(jié)論1.PSD在2周的發(fā)生率為31.96%,以輕度抑郁為主,卒中后抑郁應引起臨床重視。2.在女性、合并癥多、左側(cè)大腦半球病變的急性腦卒中患者更易發(fā)生抑郁。3.神經(jīng)功能缺損重的患者更易發(fā)生PSD。4.合并癥個數(shù)、NIHSS評分可能為PSD的獨立危險因素。
[Abstract]:Objective 1. To study the incidence and clinical characteristics of post-stroke depression in patients with acute stroke. To compare the clinical data and laboratory examination between patients with acute post-stroke depression and those with non-depression after acute stroke. Logistic regression analysis was used to further understand the risk factors of depression after acute stroke. Methods prospective and observational clinical study methods were used. A total of 97 consecutive patients with acute stroke (within 7 days of onset) who were hospitalized in the Department of Neurology, General Hospital of Ningxia Medical University from April 2016 to September 2016 were selected. The general data of the patients were collected, including social demographic survey. All patients were screened for depression with PHQ-9 on day 14 鹵2 after onset, and were divided into post-stroke depression group and post-stroke non-depressive group, and their MMSE NIHSS and ADL scores were evaluated. Results 1. General data: a total of 97 patients, 31 patients with depression, male: female 15: 16, mild depression 29 cases, moderate depression 2 cases. 2. Age, marital status, education, occupation, overweight and obesity, body mass index, living condition, income, type of medical insurance, solitary living, blood type, past history, smoking, drinking, The incidence of PSD in Hui nationality patients was higher than that in Han nationality patients (35.71 vs 31.33). There was no statistical difference between the two groups. There were 16 women in the two groups, and the incidence rate was 44.44% 16 / 366,15 males. The incidence of PSD in the two groups was significantly higher than that in the first stroke group. The incidence of PSD in two or more patients was significantly higher than that in the first stroke group, and the difference between the two groups was statistically significant. The incidence of PSD in multiple stroke patients was higher than that in the first stroke group. However, there was no significant difference between the two groups in terms of the type of stroke (p0.369), the number of lesions, the infarct area p1.000, the frontal lobe p0.581m, the parietal lobe p0.743, the temporal lobe p1.000, the occipital lobe p0.455a, the thalamus p1.000, the basal ganglia p0.54646, the lateral ventriculus p0.735, the cerebellum p1.000), but there was no significant difference between the two groups, but there was no significant difference between the two groups. The NIHSS score of PSD group was significantly higher than that of non-#en2# group, and that of PSD group was lower than that of non-#en4# group. Logistic regression analysis showed that PSD was closely related to the number of complications and NIHSS score. Conclusion 1. The incidence of PSD in 2 weeks was 31.966.The incidence of mild depression was mainly mild, and post-stroke depression should cause clinical attention. Patients with acute cerebral apoplexy with left hemisphere lesions were more likely to develop depression, and patients with severe neurological impairment were more likely to develop PSD.4.The number of complications and NIHSS scores might be independent risk factors of PSD.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743.3;R749.4

【參考文獻】

相關期刊論文 前10條

1 張國平;王莉莉;王海燕;;腦卒中后抑郁與神經(jīng)功能缺損關系研究[J];中國現(xiàn)代神經(jīng)疾病雜志;2016年05期

2 范清雨;展淑琴;吳海琴;;腦卒中后抑郁與認知功能的關系研究[J];卒中與神經(jīng)疾病;2015年06期

3 梁晨;陳文權;高社榮;;老年腦卒中后抑郁與血管事件的相關性分析[J];中國全科醫(yī)學;2015年05期

4 王娟;李志偉;余雨;;腦卒中后抑郁的相關因素研究[J];重慶醫(yī)學;2014年24期

5 林穎;劉亞紅;楊f ;李明泉;趙群;李敏;殷勤;陳光輝;劉玲;;315例腦卒中后抑郁的臨床研究[J];中華老年心腦血管病雜志;2013年09期

6 李靜;鄭振雨;郭康;宋景貴;;卒中后抑郁患者載脂蛋白H與血脂的相關研究[J];中國現(xiàn)代醫(yī)藥雜志;2013年01期

7 郝貴峰;李修奎;胡晉懷;張繼香;王師華;季濤;劉偉;呂晶;;不同臨床類型腦卒中后抑郁癥患者健康相關生存質(zhì)量及其影響因素[J];精神醫(yī)學雜志;2012年06期

8 王素平;溫秀蓮;;急性腦梗死后抑郁50例相關因素臨床分析[J];包頭醫(yī)學院學報;2012年01期

9 楊述鳴;張曉平;王守峰;宋黎剛;;早期心理干預聯(lián)合康復訓練治療腦卒中后抑郁癥的療效觀察[J];中華物理醫(yī)學與康復雜志;2011年04期

10 欒軍祥;張向榮;張志瑤;;卒中后抑郁的發(fā)生率及其相關因素的前瞻性研究[J];中國卒中雜志;2010年01期

相關會議論文 前1條

1 楊文明;;大面積腦梗死的診斷與治療[A];中國中西醫(yī)結(jié)合學會養(yǎng)生學與康復醫(yī)學專業(yè)委員會委員會議暨第八次學術研討會論文集[C];2013年

，

本文編號：1625445