CAJ | 학술논문

目的探讨首发脑卒中患者抑郁（PSD）的发生率及其相关因素。方法收集169例首发脑卒中患者，应用汉密尔顿抑郁量17项（HAMD-17）进行抑郁症状评定PSD，比较不同年龄、病灶性质、部位、抑郁程度的PSD发生率，及不同病灶部位的HAMD-17评分。并进行logisitic 回归。结果 HAMD-17评分≥16的83例，首发PSD的发生率为50.89％；不同性别、病变性质及左右半球病变部位的PSD发生率比较，差异均无统计学意义（χ2分别=1.73、2.71、3.29， P均＞0.05）；首发脑卒中后3～6个月与2月内及7～12个月比较，PSD发生率差异有统计学意义（χ2=3.82、4.15， P＜0.05），与7～12个月比较，前6个月内的PSD发生率差异有统计学意义（χ2=3.19，P＜0.05）；轻度神经功能缺损中PSD发生率22.92％（11/48）、中度为57.02％（47/85）、重度为69.44％（25/36），中度PSD发生率高于轻度，重度高于中度，差异均有统计学意义（χ2分别=4.12、4.38， P均＜0.05）；不同病灶部位的HAMD-17评分比较显示，前后半球比较及右前半球、左后半球、右后半球与左前半球比较，差异均有统计学意义（t分别=2.84、4.62、3.75、4.02，P均＜0.05）。 Spearman秩相关分析显示，PSD的发病率与神经功能缺损程度及前半球、左前半球部位的病灶有相关性（r分别=0.79、0.84、0.81，P均＜0.05）。结论首发PSD的发生率较高，高峰期为第3个月至第6个月；与前半球、左前半球部位的病灶及神经功能缺损严重程度相关。
목적탐토수발뇌졸중환자억욱（PSD）적발생솔급기상관인소。방법수집169례수발뇌졸중환자，응용한밀이돈억욱량17항（HAMD-17）진행억욱증상평정PSD，비교불동년령、병조성질、부위、억욱정도적PSD발생솔，급불동병조부위적HAMD-17평분。병진행logisitic 회귀。결과 HAMD-17평분≥16적83례，수발PSD적발생솔위50.89％；불동성별、병변성질급좌우반구병변부위적PSD발생솔비교，차이균무통계학의의（χ2분별=1.73、2.71、3.29， P균＞0.05）；수발뇌졸중후3～6개월여2월내급7～12개월비교，PSD발생솔차이유통계학의의（χ2=3.82、4.15， P＜0.05），여7～12개월비교，전6개월내적PSD발생솔차이유통계학의의（χ2=3.19，P＜0.05）；경도신경공능결손중PSD발생솔22.92％（11/48）、중도위57.02％（47/85）、중도위69.44％（25/36），중도PSD발생솔고우경도，중도고우중도，차이균유통계학의의（χ2분별=4.12、4.38， P균＜0.05）；불동병조부위적HAMD-17평분비교현시，전후반구비교급우전반구、좌후반구、우후반구여좌전반구비교，차이균유통계학의의（t분별=2.84、4.62、3.75、4.02，P균＜0.05）。 Spearman질상관분석현시，PSD적발병솔여신경공능결손정도급전반구、좌전반구부위적병조유상관성（r분별=0.79、0.84、0.81，P균＜0.05）。결론수발PSD적발생솔교고，고봉기위제3개월지제6개월；여전반구、좌전반구부위적병조급신경공능결손엄중정도상관。
Objective To explore the influencing factors of post-stroke depression patients. Methods A total of 169 cases of initial stroke were enrolled in the study. The post-stroke depression (PSD) was assessed by HAMD-17. The inci-dence of PSD of different ages, the nature of the lesion, lesion, the degree of depression and HAMD-17 scores were com-pared and the logistic regression were performed at the same time. Results There were 83 cases that the score of HAMD-17 were higher than 16. The incidence of PSD was 50.89%. There were no statistically significant differences of PSD incidence among different gender, pathological changes and left or right hemisphere lesions(χ2=1.73, 2.71, 3.29, P>0.05). Compared with that in 2 months and during 7 to12 months after stroke, the incidence of PSD during 3 to 6 months were statistically dif-ferent(χ2=3.82, 4.15, P<0.05);Compared with 7 to12 months after stroke, the PSD incidence within 6 months was statisti-cally different(χ2=3.19, P<0.05). The PSD incidence in mild nerve function defect patients was 22.92%, which was signifi-cantly lower than that in moderate nerve function defect patients (57.02%) that was also significantly lower than that in the severe nerve function defect patients (69.44%)(χ2=4.12,4.38,P<0.05). The HAMD-17 score comparisons between the for-mer and poster-hemisphere, the left-former hemisphere and the right-former hemisphere, left-poster hemisphere and right-poster hemisphere were statistically different (t=2.84, 4.62, 3.75, 4.62, P<0.05). The spearman correlation showed that the PSD incidence was related to the nerve function defect, the former hemisphere and the left-former hemisphere (r=0.79,0.84,0.81,P<0.05). Conclusion The incidence of PSD is high, especially during the third months to the six months. It relate to the former hemispheres, the left-former hemisphere nervous lesion and the heavier degree of nervous function deficit.