健身活动与社会交往和用脑习惯对老年首发缺血性脑卒中患者抑郁症状的影响研究

摘要

目的 分析健身活动、社会交往和用脑习惯对老年首发缺血性脑卒中患者抑郁症状的影响.方法2016年6月—2017年7月,选取济宁医学院附属医院神经内科就诊的符合纳入标准的首次发病的老年缺血性脑卒中患者916例为调查对象.患者发病后3个月,由经过培训的神经内科医护人员进行问卷调查.调查问卷包括一般状况调查表〔性别、年龄、民族、婚姻状况、文化程度、健身活动参与情况(剧烈健身活动、中等强度健身活动、轻度休闲健身活动)、社会交往情况(与子女、朋友交流次数)和用脑习惯(阅读、下棋)〕、简版老年抑郁量表(GDS-15)、病变部位〔脑卒中位置(左/右、前/后)、脑卒中部位〕、美国国立卫生院脑卒中量表(NIHSS)评分.采用单因素、多因素Logistic回归分析分析老年首发缺血性脑卒中患者发生抑郁症状的影响因素.结果 共发放调查问卷916份,回收有效问卷764份,有效回收率为83.4%.764例脑卒中患者中有抑郁症状70例(9.2%),无抑郁症状694例(90.8%).单因素Logistic回归分析显示,轻度休闲健身活动〔OR=0.451,95%CI(0.253,0.805)〕、与朋友交流次数〔OR=0.176, 95%CI(0.103,0.301)〕、脑卒中位置(前/后)〔OR=2.359,95%CI(1.510,3.562)〕、NIHSS评分〔OR=1.817, 95%CI(1.166,3.358)〕是老年首发缺血性脑卒中患者发生抑郁症状的影响因素(P＜0.05).多因素Logistic回归分析显示,轻度休闲健身活动〔OR=0.503,95%CI(0.277,0.915)〕、与朋友交流次数〔OR=0.189,95%CI(0.110, 0.326)〕、脑卒中位置(前/后)〔OR=2.487,95%CI(1.497,4.134)〕、NIHSS评分〔OR=1.901,95%CI(1.154, 3.130)〕是老年首发缺血性脑卒中患者发生抑郁症状的影响因素(P＜0.05).结论 参加轻度休闲健身活动、多与朋友交流是老年首发缺血性脑卒中患者发生抑郁症状的保护因素,而脑卒中位置位于前部及NIHSS评分≥5分是老年首发缺血性脑卒中患者发生抑郁症状的危险因素;用脑习惯与老年首发缺血性脑卒中患者发生抑郁症状的关系不显著.%Objective To analyze the influence of fitness activities,social interactions and brain habits on the depressive symptoms of elderly patients with newly diagnosed ischemic stroke.Methods A total of 916 elderly patients with first-onset ischemic stroke who were treated in the Department of Neurology of the Affiliated Hospital of Jining Medical University between June 2016 and July 2017 and met the inclusion criteria were selected as study subjects.Three months after the onset of the disease,a questionnaire survey was conducted by trained neurosurgical staff.The items in the questionnaire comprised general information including sex,age,ethnicity,marital status,education level,participation in fitness activities(intensive, moderate and leisure fitness activities),social activities(communication frequency with families and friends) and brain habits (reading and playing chess),geriatric depression scale(GDS-15) score,lesion locations(stroke lesion in the left/right or anterior/posterior,as well as specific stroke sites),and NIH stroke scale(NIHSS) score.Univariate and multivariate Logistic regression were used to analyze factors influencing the depression symptoms in elderly patients with newly diagnosed ischemic stroke.Results A total of 916 questionnaires were distributed,and 764 valid questionnaires were collected.The effective recovery rate was 83.4%.Of the 764 stroke patients,70(9.2%) had depressive symptoms,and 694(90.8%) had no depressive symptoms.Univariate Logistic regression analysis showed that mild leisure fitness activities〔OR=0.451,95%CI(0.253,0.805)〕, the frequency of interaction with families or friends〔OR=0.176,95%CI(0.103,0.301)〕,the stroke position(anterior/posterior)〔OR=2.359,95%CI(1.510,3.562)〕,and the NIHSS score〔OR=1.817,95%CI(1.166,3.358)〕 were the factors associated with depressive symptoms in elderly patients with ischemic stroke(P＜0.05).Multivariate Logistic regression analysis showed that mild leisure fitness activities〔OR=0.503,95%CI(0.277,0.915)〕,the frequency of interaction with families or friends〔OR=0.189,95%CI(0.110,0.326)〕,the stroke position(anterior/posterior)〔OR=2.487,95%CI(1.497, 4.134)〕,and the NIHSS score〔OR=1.901,95%CI(1.154,3.130)〕 were the factors associated with depressive symptoms in elderly patients with ischemic stroke(P＜0.05).Conclusion Participating in mild leisure fitness activities and communicating with friends are protective factors against depressive symptoms in elderly patients with newly diagnosed ischemic stroke.Stroke in the anterior brain and an NIHSS score ≥ 5 are the risk factors for depression in elderly patients with newly diagnosed ischemic stroke.The relationship between brain habits and depressive symptoms was not significant in the population.