卒中后抑郁的影像学及中医证候特点

摘要

目的:研究卒中后抑郁(PSD)的发生率与相关因素及其与中风病中医证候的相关性.方法:对134例脑卒中患者进行一般资料记录、卒中部位分析、中风病中医证候评分、神经功能缺损程度评分、日常生活能力评分(ADL)及汉密顿抑郁量表(HAMD)17项版本评分,依据HAMD得分将患者分为PSD组和非PSD组,观察性别、年龄、职业、文化程度、卒中病程、卒中性质、脑损伤部位、神经功能缺损程度及日常生活能力等因素与PSD的关系；同时采用中风病中医证候诊断标准对患者的症状、体征、舌脉等进行评定,观察PSD与中风病中医证候的关系.结果:PSD的发生率为56.7％,PSD与性别、年龄、职业、文化程度、卒中性质及卒中病程等因素无明显相关性,与日常生活能力、神经功能缺损程度、脑损伤部位(大脑前部、颞叶、基底节区)等因素相关.PSD的发生与中风病肝阳上亢证候有关.结论:PSD的发生率较高,与日常生活能力、神经功能缺损程度、脑损伤部位等因素有关,表明PSD的发病与生物、社会、心理等多因素相关,其发生与中风病的证侯密切相关.%Objective:To study the incidence,and the related factors and syndromes differentiation of the post-stroke depression(PSD).Methods:134 patients with stroke were assessed by the social demeographic character-istics,the syndrome in TCM,the neurologic function assessment,the Activity of Daily Living Scale (ADL)and Hamilton Depression Scale(HAMD).The we used one-example analysis and the logistic multiple regression method to compare the related factors and related the syndrome of the two groups,the PSD groups and non-PSD groups.Results:The incident rate of PSD was 56.7％.Among all the related factors,sex,age,occupation,culture degree,stroke type,stroke time haven' t significant effect on PSD.But the neurologic function assessment,the Activity of Daily Living Scale,stroke localization have striking correlation with PSD.We also found that the hyperactivity of liver yang are the related syndrome of the PSD.Conclusion:The incident rate of PSD was high,the study suggested that PSD had a close relationship with biology,sociology and psychology.It was suggested that the syndrome of the storke patients related with the onset of PSD.