中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
31期
31-34
,共4页
林香玉%李玉辉%李静%张金刚%陈润青
林香玉%李玉輝%李靜%張金剛%陳潤青
림향옥%리옥휘%리정%장금강%진윤청
脑出血%抑郁症%危险因素%脑血流量
腦齣血%抑鬱癥%危險因素%腦血流量
뇌출혈%억욱증%위험인소%뇌혈류량
Cerebral hemorrhage%Depressive disorder,Risk factor%Cerebral blood flow
目的 探讨脑出血恢复期抑郁症的相关危险因素及防治对策.方法 选择98例脑出血恢复期患者,用汉密尔顿抑郁量表(HAMD)进行抑郁症评估,以国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评估,用蒙特利尔认知量表(MoCA)进行认知功能评估,用改良Rankin量表(mRS)进行神经功能恢复情况评估.颅脑CT确定脑出血的部位、出血量.经颅多普勒测定大脑中动脉、大脑前动脉和大脑后动脉的脉冲频谱和血流参数.结果 98例脑出血恢复期患者中抑郁症发生率为51.0％(50/98),其中男性发生率为34.0％(17/50),女性发生率为68.8％(33/48),两者比较差异有统计学意义(P＜0.05).经过等级相关系数检验,NIHSS、mRS评分与HAMD评分呈正相关(P＜0.05),与MoCA评分呈负相关(P＜0.05).出血部位为额叶时抑郁症发生率较高[76.2％(16/21)],脑出血量在20～40 ml时抑郁症发生率较高[62.5％(25/40)].脑出血恢复期患者中,抑郁症患者的大脑中动脉、大脑前动脉平均血流速度低于非抑郁症患者,阻力指数高于非抑郁症患者,差异均有统计学意义(P＜0.05).结论 脑出血恢复期抑郁症的发生与NIHSS、MoCA评分及性别、出血部位、出血量有显著的相关性.抑郁症患者的脑血流速度明显低于非抑郁症患者,阻力指数明显高于非抑郁症患者.
目的 探討腦齣血恢複期抑鬱癥的相關危險因素及防治對策.方法 選擇98例腦齣血恢複期患者,用漢密爾頓抑鬱量錶(HAMD)進行抑鬱癥評估,以國立衛生研究院卒中量錶(NIHSS)進行神經功能缺損評估,用矇特利爾認知量錶(MoCA)進行認知功能評估,用改良Rankin量錶(mRS)進行神經功能恢複情況評估.顱腦CT確定腦齣血的部位、齣血量.經顱多普勒測定大腦中動脈、大腦前動脈和大腦後動脈的脈遲頻譜和血流參數.結果 98例腦齣血恢複期患者中抑鬱癥髮生率為51.0％(50/98),其中男性髮生率為34.0％(17/50),女性髮生率為68.8％(33/48),兩者比較差異有統計學意義(P＜0.05).經過等級相關繫數檢驗,NIHSS、mRS評分與HAMD評分呈正相關(P＜0.05),與MoCA評分呈負相關(P＜0.05).齣血部位為額葉時抑鬱癥髮生率較高[76.2％(16/21)],腦齣血量在20～40 ml時抑鬱癥髮生率較高[62.5％(25/40)].腦齣血恢複期患者中,抑鬱癥患者的大腦中動脈、大腦前動脈平均血流速度低于非抑鬱癥患者,阻力指數高于非抑鬱癥患者,差異均有統計學意義(P＜0.05).結論 腦齣血恢複期抑鬱癥的髮生與NIHSS、MoCA評分及性彆、齣血部位、齣血量有顯著的相關性.抑鬱癥患者的腦血流速度明顯低于非抑鬱癥患者,阻力指數明顯高于非抑鬱癥患者.
목적 탐토뇌출혈회복기억욱증적상관위험인소급방치대책.방법 선택98례뇌출혈회복기환자,용한밀이돈억욱량표(HAMD)진행억욱증평고,이국립위생연구원졸중량표(NIHSS)진행신경공능결손평고,용몽특리이인지량표(MoCA)진행인지공능평고,용개량Rankin량표(mRS)진행신경공능회복정황평고.로뇌CT학정뇌출혈적부위、출혈량.경로다보륵측정대뇌중동맥、대뇌전동맥화대뇌후동맥적맥충빈보화혈류삼수.결과 98례뇌출혈회복기환자중억욱증발생솔위51.0％(50/98),기중남성발생솔위34.0％(17/50),녀성발생솔위68.8％(33/48),량자비교차이유통계학의의(P＜0.05).경과등급상관계수검험,NIHSS、mRS평분여HAMD평분정정상관(P＜0.05),여MoCA평분정부상관(P＜0.05).출혈부위위액협시억욱증발생솔교고[76.2％(16/21)],뇌출혈량재20～40 ml시억욱증발생솔교고[62.5％(25/40)].뇌출혈회복기환자중,억욱증환자적대뇌중동맥、대뇌전동맥평균혈류속도저우비억욱증환자,조력지수고우비억욱증환자,차이균유통계학의의(P＜0.05).결론 뇌출혈회복기억욱증적발생여NIHSS、MoCA평분급성별、출혈부위、출혈량유현저적상관성.억욱증환자적뇌혈류속도명현저우비억욱증환자,조력지수명현고우비억욱증환자.
Objective To evaluate the melancholia incidence in the convalescence period of cerebral hemorrhage and its correlated factors.Methods Ninety-eight cerebral hemorrhage patients in the convalescence period were involved in this study.Melancholia was assessed by Hamilton depression scale (HAMD),neural functional deficiency was assessed by the national institute of health stroke scale (NIHSS),cognitive function deficiency was assessed by the Montreal cognitive assessment (MoCA) and neural functional deficiency recovery was assessed by modified Rankin scale (mRS).Hemorrhagic site and blood quantity were detected with CT.The blood flow of middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA) was detected by TCD.Results The melancholia incidence in the convalescence period was 51.0％(50/98),34.0％(17/50) in males and 68.8％(33/48) in females,there was significant difference between the two (P ＜ 0.05 ).The scores of NIHSS and mRS had significantly positive correlation with HAMD (P ＜ 0.05 ),and had significantly negative correlation with MoCA (P ＜ 0.05 ).When the hemorrhagic site was in frontal lobe and blood quantity was 20-40 ml,the melancholia incidence was increased [76.2％ (16/21),62.5％ (25/40)].The average blood velocity of MCA,ACA and PCA in melancholia patients was significantly slower than that without melancholia patients,while resistance index was significantly higher in melancholia patients (P ＜ 0.05).Conclusions Melancholia incidence in the convalescence period of cerebral hemorrhage has positive correlation with sex,NIHSS,MoCA,hemorrhagic site and blood quantity.The average cerebral blood flow in the melancholia patients is significantly slower and resistance index is significantly higher.
