缺血性卒中患者急性期淡漠情绪障碍的影响因素研究

摘要

目的：探讨缺血性卒中患者急性期淡漠情绪障碍的影响因素。方法选取2013年6月—2015年6月首都医科大学附属北京潞河医院收治的缺血性卒中患者94例，按是否发生急性期淡漠情绪障碍分为淡漠组34例与对照组60例。收集两组患者的临床资料，分析缺血性卒中患者急性期淡漠情绪障碍的危险因素。结果两组患者性别、饮酒史阳性率、吸烟史阳性率、高血压发生率、冠心病发生率、糖尿病发生率、枕叶病变发生率、顶叶病变发生率、颞叶病变发生率、皮质下白质病变发生率、中脑病变发生率、半球病变发生率、丘脑病变发生率、延髓病变发生率、小脑病变发生率、总胆固醇水平、高密度脂蛋白水平、低密度脂蛋白水平、三酰甘油水平、纤维蛋白原水平比较，差异无统计学意义（P >0.05）；淡漠组患者额叶病变发生率、基底核病变发生率、卒中史阳性率、年龄、美国国立卫生研究院卒中量表（NIHSS）评分、同型半胱氨酸（Hcy）水平高于对照组（P <0.05）。多因素 logistic 回归分析结果显示，额叶病变〔OR =8.317，95% CI（2.032，34.042）〕、基底核病变〔OR =6.851，95% CI（1.784，26.310）〕、卒中史〔OR =4.998，95% CI（1.531，16.316）〕、年龄〔 OR =2.931，95% CI（1.314，6.538）〕、NIHSS 评分〔 OR=3.824，95% CI（1.635，8.944）〕、Hcy〔OR =2.715，95% CI（1.293，5.701）〕是缺血性卒中患者急性期淡漠情绪障碍的危险因素（P <0.05）。结论额叶病变、基底核病变、卒中史、年龄、NIHSS 评分、Hcy 是缺血性卒中患者急性期淡漠情绪障碍的危险因素。%Objective To analyze the influencing factors of acute indifference mood disorders in patients with ischemic stroke. Methods A total of 94 patients with ischemic stroke were selected in Beijing Luhe Hospital Affiliated to Capital Medical University from June 2013 to June 2015,and they were divided into study group( complicated with acute indifference mood disorders,n = 34)and control group(did not complicated with acute indifference mood disorders,n = 60) according to the incidence of acute indifference mood disorders. Clinical data of the two groups was collected,and the influencing factors of acute indifference mood disorders in patients with ischemic stroke were analyzed. Results No statistically significant differences of gender,positive rate of drinking history or smoking history,incidence of hypertension,coronary heart disease,diabetes, occipital lobe lesions,parietal lobl lesions,temporal lobe lesions,subcortical white matter lesions,midbrain lesions,cerebral hemisphere lesions,thalamus lesions,medulla oblongata lesions or cerebellar lesions,TC,HDL,LDL,TG or fibrinogen was found between the two groups(P > 0. 05),while the incidence of frontal lobe lesions and basal ganglia lesions,positive rate of stroke history,age,NIHSS score and Hcy of study group were statistically significantly higher than those of control group(P <0. 05). Multivariate logistic regression analysis showed that,frontal lobe lesions〔OR = 8. 317,95% CI(2. 032,34. 042)〕, basal ganglia lesions〔OR = 6. 851,95% CI(1. 784,26. 310)〕,stroke history〔OR = 4. 998,95% CI(1. 531,16. 316)〕, age〔OR = 2. 931,95% CI(1. 314,6. 538)〕,NIHSS score〔 OR = 3. 824,95% CI(1. 635,8. 944)〕and Hcy〔 OR= 2. 715,95% CI(1. 293,5. 701)〕were risk factors of acute indifference mood disorders in patients with ischemic stroke(P< 0. 05). Conclusion Frontal lobe lesions,basal ganglia lesions,stroke history,age,NIHSS score and Hcy are risk factors of acute indifference mood disorders in patients with ischemic stroke.