CAJ | 학술논문

目的探讨缺血性脑卒中患者早期疲劳症状的发生率以及临床和神经心理学方面的影响因素.方法共选取108例急性缺血性脑卒中患者,在卒中后1～3周内进行神经心理学评估.采用疲劳严重度量表(FSS)判定入选患者有无卒中后疲劳(PSF),并根据该结果将患者分为PSF组及非PSF组.采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)分别评估患者抑郁及焦虑症状；采用简易智能状态检查量表(MMSE)评定患者认知功能.通过比较PSF组及非PSF组临床因素及神经心理学结果(包括HAMA、HAMD及MMSE评分)组间差异,应用logistic回归分析PSF的影响因素.结果共有33例(30.6％)患者存在PSF.当将HAMA评分纳入logistic回归分析时,发现入院时美国国立卫生研究院卒中量表(NIHSS)评分(OR值为1.222,P ＜0.05)及HAMA评分(OR值为1.311,P＜O.01)均为PSF有显著统计学意义的预测因素；当将HAMD评分纳入logistic回归分析时,仅发现HAMD评分(OR值为1.217,P＜0.001)为PSF有显著统计学意义的预测因素.结论 PSF在国内缺血性脑卒中患者中较常见,患者抑郁及焦虑症状均为PSF的主要影响因素.
목적 탐토결혈성뇌졸중환자조기피로증상적발생솔이급림상화신경심이학방면적영향인소.방법 공선취108례급성결혈성뇌졸중환자,재졸중후1～3주내진행신경심이학평고.채용피로엄중도량표(FSS)판정입선환자유무졸중후피로(PSF),병근거해결과장환자분위PSF조급비PSF조.채용한밀이돈억욱량표(HAMD)급한밀이돈초필량표(HAMA)분별평고환자억욱급초필증상；채용간역지능상태검사량표(MMSE)평정환자인지공능.통과비교PSF조급비PSF조림상인소급신경심이학결과(포괄HAMA、HAMD급MMSE평분)조간차이,응용logistic회귀분석PSF적영향인소.결과 공유33례(30.6％)환자존재PSF.당장HAMA평분납입logistic회귀분석시,발현입원시미국국립위생연구원졸중량표(NIHSS)평분(OR치위1.222,P ＜0.05)급HAMA평분(OR치위1.311,P＜O.01)균위PSF유현저통계학의의적예측인소；당장HAMD평분납입logistic회귀분석시,부발현HAMD평분(OR치위1.217,P＜0.001)위PSF유현저통계학의의적예측인소.결론 PSF재국내결혈성뇌졸중환자중교상견,환자억욱급초필증상균위PSF적주요영향인소.
Objective To investigate the frequency,as well as the clinical and psychological correlates of post-stroke fatigue (PSF) in patients with ischemic stroke.Methods A total of 108 patients with acute ischemic stroke participated in this study.At one to three weeks after the onset of stroke,all participants received comprehensive neuropsychological assessments including fatigue,depression,anxiety and global cognitive function.Severity of fatigue symptom was evaluated using the Fatigue Severity Scale (FSS).PSF was defined as a mean FSS score of 4.0 or more.Depressive and anxious symptoms were measured using the Hamilton Depression and Anxiety Scales (HAMD and HAMA).The global cognitive function was measured using the Mini-mental Status Examination (MMSE).The clinical and neuropsychological variables were compared between the PSF and non-PSF groups.Logistic regressions were performed to find the correlates of PSF.Results The mean (SD) age of the 108 patients was (61.6 ± 12.1) years.eighty-one (75.0％) were male and 14 (13.0％) had at least a previous stroke.Thirty-three (30.6％) were diagnosed as having PSF.Patients in the PSF group had a significant higher NIH stroke score (N1HSS) on admission,higher frequency of pre-stroke fatigue,and higher HAMD and HAMA scores (P ＜0.05),when compared with those in the non-PSF group.NIHSS on admission (OR=1.222,P=0.015) and HAMA score (OR=1.311,P＜0.001) were significant correlates of PSF with HAMA score entered into the logistic regression model.When HAMD score was entered,it(OR =1.217,P ＜ 0.001) became the only significant correlate of PSF.Conclusions PSF is common in Chinese patients with ischemic stroke.Depressive and anxious symptoms are the major determinants of PSF.