【摘要】 目的探讨脑卒中后不同时段抑郁的发生情况及与预后的关系。方法急性期脑卒中病例223例,卒中后72h予HAMD评分,将≥8分者随机分为抗抑郁药物组(干预组)、对照组,<8分者1月再予评分,将其中≥8分者用相同方法再分为干预组、对照组,<8分者2月再予评分,将其中≥8分者用相同方法再分为干预组、对照组,将<8分者3M再次评分,分为≥8分、<8分组,各组卒中后3月予MoCa、NIHSS评分、mRS分级。分析卒中后不同时段抑郁的发生情况,比较分析各时段对照组3月时MoCa、NIHSS评分、mRS分级。结果卒中后抑郁(PSD)的发生率分别为72h内19.73%,1月时35.03%,2月时53.51%,3月时46.15%;各对照组3月时MoCa评分比较,72h组与其余各组均有明显差异,P均<0.01;NIHSS评分比较,72h组与1、2月组均有显著差异P均<0.05;各组预后良好率(mRS分级)比较P均>0.05。结论卒中后急性期(72h)的发病率偏低,恢复期(2~3月)的发病率较高。急性期PSD对认知功能的影响较小,但抑郁越早发生,对神经功能的恢复影响越大,致残程度越严重。更多还原

【Abstract】 Objective To study the incidence of post-stroke depression(PSD) in different periods and relationship with prognosis.Methods To choose 223 cases who had been diagnosed as acute cerebral apoplexy,firstly,all patients must finish the HAMD in 72 hours after stroke and the patients who got score ≥8 were randomly divided into antidepressant drugs intervention group and control group.In 1 and 2 months,the Patients who got score <8 again were evaluated by HAMD.Patients who gor ≥8 points were divided by the same way as above.Finally,in 3 months after stroke,the patients who still got score <8 were evaluated by HAMD again,and divided into ≥8 and <8 groups.Each group of all patients needed to finish MoCa scale score,NIHSS score,and mRS grading at the end of 3 month after stroke.By comparing the results of MoCa score,NIHSS score and mRS grading of control groups in 3 months after stroke,we wanted to know the development of post-stroke depression(PSD) in different periods.Results The incidence rate of post-stroke depression(PSD) at different stages was 19.73% in 72 h,35.03% in 1m,53.51% in 2m and 46.15% in 3m respectively;Compared the MoCa scores of 72h control groups with the 1M,2M,3M control group respectively there was marked statistical difference(P<0.01);Compared NIHSS scores of the 72h control group with 1M,2M,3M control group respectively,there was statistical difference.The mRS results showed good prognosis rates,there was no statistcal difference(P>0.05).Conclusions In the acute phase(72h),the incidence is low,but in the recovery phase(2~3M),it is a higher prevalence.PSD in acute phase affects on cognitive function smaller,but the earlier occurrence of depression,the worse recovery of nerve function and the more serious disability.更多还原