| 陈奕菲,张春鹏,王慎安,等.脑卒中患者脑白质高信号相关因素及其与卒中后抑郁的关系[J].中国临床保健杂志,2021,24(5):663-666. |
| 脑卒中患者脑白质高信号相关因素及其与卒中后抑郁的关系 |
| The relationship between the related factors of white matter hyperintensities and post-stroke depression in stroke patients |
| 投稿时间：2021-05-06 |
| DOI：10.3969/J.issn.1672-6790.2021.05.018 |
| 中文关键词: 卒中 脑白质高信号 抑郁 糖尿病 高血压 危险因素 老年人 |
| 英文关键词: Stroke White matter hyperintensities Depression Diabetes mellitus Hypertension Risk factors Aged |
| 基金项目:北京市医院管理局2018年度“青苗”计划科研项目(QML20180106) |
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| 中文摘要: |
| 目的 探究脑卒中患者重度脑白质高信号(WMHs)相关因素及其与卒中后抑郁(PSD)的关系。方法 以2018年5月至2020年12月北京友谊医院平谷医院收治的187例急性缺血性脑卒中患者为研究对象,根据Fazekas评分将患者分为重度WMHs组(Fazekas评分≥3分)和轻度WMHs组(Fazekas评分＜3分),比较两组患者一般资料,采用多元logistics回归分析影响患者出现重度WMHs的危险因素；根据发病后1个月抑郁发生情况分为PSD组[汉密尔顿抑郁量表(HAMD)评分＞8分]和非PSD组(HAMD评分≤8分),比较两组脑小血管病总体负担指标,分析脑小血管病总体负担指标与PSD发生的关系及对PSD发生的预测价值。结果 重度WMHs组年龄≥60岁、高血压、糖尿病、体重指数(BMI)≥24 kg/m2的人数比例高于轻度WMHs组(P＜0.05)；年龄≥60岁、糖尿病、高血压是影响重度WMHs发生的危险因素(P＜0.05)；PSD组重度WMHs、脑微出血、腔隙性脑梗死及血管周围间隙扩大阳性率大于非PSD组(P＜0.05)；重度WMHs预测PSD发生的AUC高于脑微出血、腔隙性脑梗死、血管周围间隙扩大(P＜0.05)；重度WMHs是影响急性脑卒中患者出现PSD的危险因素(P＜0.05)。结论 年龄≥60岁、糖尿病、高血压是影响重度WMHs发生的危险因素,且重度WMHs对PSD发生具有预测价值。 |
| 英文摘要: |
| Objective To explore the related factors of severe white matter hyperintensities (WMHs) and the relationship between WMHs and post-stroke depression (PSD) in stroke patients.Methods A total of 187 patients with acute ischemic stroke from May 2018 to December 2020 were enrolled as the research objects in Beijing Friendship Hospital Pinggu Campus.According to Fazekas scores,they were divided into severe WMHs group (Fazekas score not lower than 3 points) and mild WMHs group (Fazekas score lower than 3 points).The general data were compared between the two groups.The risk factors of severe WMHs were analyzed by multivariate Logistics regression analysis.According to presence or absence of depression at 1 month after onset,they were divided into PSD group [Hamilton Depression Scale (HAMD) score higher than 8 points] and non-PSD group (HAMD score not higher than 8 points).The overall burden indexes of CSVD were compared between the two groups.The relationship between these indexes and the occurrence of PSD,and their predictive value for PSD were analyzed.Results The proportion of cases with age more than 60 years old,hypertension,diabetes and BMI ≥24kg/m2 in severe WMHs group were higher those that in mild WMHs group (P＜0.05).Age more 60 years old,diabetes and hypertension were risk factors of severe WMHs (P＜0.05).The positive rates of severe WMHs,cerebral microhemorrhage,expansion of cavities and perivascular space in PSD group were higher than those in non-PSD group (P＜0.05).AUC of severe WMHs for predicting PSD was higher than that of cerebral microhemorrhage,cavity and perivascular space expansion (P＜0.05).Severe WMHs was a risk factor affecting PSD in patients with acute stroke (P＜0.05).Conclusion Age≥60,diabetes and hypertension are the risk factors of severe WMHs,which are predictive value for the occurrence of PSD. |
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