中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2009年
11期
996-998
,共3页
胡建芳%陈朝俊%余志辉%杨沛群%樊哲江
鬍建芳%陳朝俊%餘誌輝%楊沛群%樊哲江
호건방%진조준%여지휘%양패군%번철강
卒中%神经功能缺损评分%事件相关电位%抑郁
卒中%神經功能缺損評分%事件相關電位%抑鬱
졸중%신경공능결손평분%사건상관전위%억욱
Stroke%Neurological deficit score%Event - related potential%Depression
目的 研究急性卒中后抑郁(PSD)与病变部位、神经功能缺损评分(NIHSS)及事件相关电位P300的相关性.方法 采用汉密尔顿抑郁量表(HAMD)评定, 将78例首次脑卒中患者分为PSD组和非PSD组.所有患者在发病3 d内进行颅脑CT或MRI检查,2周时进行HAMD、NIHSS评分及P300检测.结果 78例急性脑卒中患者中发生PSD 32例,发生率41.03%,且其发生与病灶部位及NIHSS评分有关,病灶位于额叶的发生率明显高于基底节、顶枕叶及小脑 (P<0.05);PSD组NIHSS评分明显高于非PSD组(P<0.01);与非PSD组相比,PSD组的P300潜伏期显著延长(P<0.01),波幅显著降低(P<0.01).结论 病灶位于额叶的卒中更可能导致 PSD;神经缺损严重的患者患PSD的机率更大,而早期的P300检测可以提高对PSD的识别,有利于临床上对PSD进行早期干预,以利于脑卒中的康复.
目的 研究急性卒中後抑鬱(PSD)與病變部位、神經功能缺損評分(NIHSS)及事件相關電位P300的相關性.方法 採用漢密爾頓抑鬱量錶(HAMD)評定, 將78例首次腦卒中患者分為PSD組和非PSD組.所有患者在髮病3 d內進行顱腦CT或MRI檢查,2週時進行HAMD、NIHSS評分及P300檢測.結果 78例急性腦卒中患者中髮生PSD 32例,髮生率41.03%,且其髮生與病竈部位及NIHSS評分有關,病竈位于額葉的髮生率明顯高于基底節、頂枕葉及小腦 (P<0.05);PSD組NIHSS評分明顯高于非PSD組(P<0.01);與非PSD組相比,PSD組的P300潛伏期顯著延長(P<0.01),波幅顯著降低(P<0.01).結論 病竈位于額葉的卒中更可能導緻 PSD;神經缺損嚴重的患者患PSD的機率更大,而早期的P300檢測可以提高對PSD的識彆,有利于臨床上對PSD進行早期榦預,以利于腦卒中的康複.
목적 연구급성졸중후억욱(PSD)여병변부위、신경공능결손평분(NIHSS)급사건상관전위P300적상관성.방법 채용한밀이돈억욱량표(HAMD)평정, 장78례수차뇌졸중환자분위PSD조화비PSD조.소유환자재발병3 d내진행로뇌CT혹MRI검사,2주시진행HAMD、NIHSS평분급P300검측.결과 78례급성뇌졸중환자중발생PSD 32례,발생솔41.03%,차기발생여병조부위급NIHSS평분유관,병조위우액협적발생솔명현고우기저절、정침협급소뇌 (P<0.05);PSD조NIHSS평분명현고우비PSD조(P<0.01);여비PSD조상비,PSD조적P300잠복기현저연장(P<0.01),파폭현저강저(P<0.01).결론 병조위우액협적졸중경가능도치 PSD;신경결손엄중적환자환PSD적궤솔경대,이조기적P300검측가이제고대PSD적식별,유리우림상상대PSD진행조기간예,이리우뇌졸중적강복.
Objective To study the correlation between the acute post -stroke depression and lesion position, neurological deficit score ( NIHSS) and event - related potential of P300. Methods Hamilton Depression Rating Scale (HAMD) assessment was adopted to assess the patients of first time stroke. In 78 cases, the stroke patients were divided into groups of post - stroke depression and non-de-pression control group. All the patients were checked by brain CT or MRI within 3 days. The examina-tion of HAMD score, NIHSS score and P300 detection were carried out after 2 weeks. Results There were 32 cases of PSD among the 78 cases with acute stroke, the occurrence rate was 41. 03%. The oc-currence was related to the lesion position and NIHSS score, and the incidence of lesions located in pre-frontal lobe was significantly higher than that in basal ganglia, parietal occipital lobe and cerebellum ( P <0. 01) ; the NIHSS score of PSD group was significantly higher than that of non - PSD group; Com-pared with the non - PSD group, the incubation period of P300 in PSD group was significantly prolonged (P <0. 01) , and the amplitude was reduced significantly (P <0. 01). Conclusion Lesions located in prefrontal temporal lobe are more likely to lead to the PSD, especially in the left frontal lobe, its occur-rence is higher. It is possible for the patients with a serious neurological deficit score to have PSD, and early detection of P300 can improve the identification of PSD, which is beneficial to early intervention of PSD and the recovery of stroke.