检索历史 清除

目的 探讨老年卒中后抑郁(PSD)的筛查并分析其危险因素.方法 采用前瞻性研究,纳入220例老年缺血性卒中患者,随访到发病后1个月,最终214例完成随访.按照美国精神病学会精神障碍诊断和统计手册第4版(DSM-IV)的诊断标准,将患者分为PSD组和非PSD组.采用17项汉密尔顿抑郁量表(HAMD)对患者进行抑郁程度评价并分为轻度抑郁组、中度抑郁组和重度抑郁组.比较人口统计学和基线临床特征,采用多因素Logistic回归分析明确老年PSD的危险因素.结果(1)最终纳入214名老年缺血性卒中患者,其中PSD组84例,PSD检出率为39.25%(84/214),女性55例(65.48%),男性29例(34.52%).PSD组患者按照HAMD评分,分为轻度抑郁组51例(60.72%),中度抑郁组25例(29.76%),重度抑郁组8例(9.52%).(2)多因素Logistic回归分析显示:高龄(>75岁)、女性、无业、离婚或丧偶、脑微出血、社会家庭环境紧张、文化程度低、中重度神经功能缺损、左侧病灶是影响老年PSD的独立危险因素.结论 老年PSD较为常见,通过评估危险因素可以识别老年PSD的高危人群,以便进行早期干预,值得在临床工作中推广.

Objective To investigate the screening of elderly patients with post?stroke depression (PSD) and to analyze risk factors. Methods In this prospective study, 220 elderly patients with ischemic stroke were enrolled. At one month after onset, 214 aged patients completed follow?up. According to the DSM?IV diagnosis standard, the patients were divided into PSD and non?PSD groups. Seventeen items of the Hamilton Depression Scale (HAMD) was used to evaluate the degree of depression, and the patients were divided into mild, moderate, and severe depression groups. The demographic and baseline clinical characteristics were compared. Multivariate logistic regression analysis was used to identify the risk factors of PSD in individuals. Results (1) Of the 214 aged patients with ischemic stroke who completed follow?up, 84 had PSD including 29 (34.52%) men and 55 (65.48%) women. The detection rate of PSD was 39.25%. According to the HAMD, 51 (60.72%) aged patients were diagnosed with mild depression, 25 (29.76%) with moderate depression, and 8 (9.52%) with serious depression. (2) Multivariate logistic regression analysis showed that advanced age (>75 years old), female sex, joblessness, being divorced or widowed, having cerebral microbleeds, experiencing social and family environment tension, having low cultural exposure, having moderate and severe neurologic deficits, and having a left?side lesion were the independent risk factors of PSD in elderly patients. Conclusion PSD is common in elderly patients. Evaluation of these risk factors can help identify aged patients at high risk for PSD to allow early intervention, which is worth promoting in clinical work.