脑卒中后康复阶段抑郁的危险因素分析

Risk factors for post-stroke depression in rehabilitation stage

摘要:

目的：研究脑卒中后康复阶段抑郁的发生率及相关危险因素，确定该阶段需要关注的脑卒中后抑郁症状群。方法：横断面调查2017年3月至2018年1月于两家三甲医院康复科治疗的126名脑卒中住院患者的病例资料，采用抑郁自评量表（self-rating depression scale，SDS）评估患者的抑郁症状，分析其影响因素。结果：单因素和多因素分析结果显示，美国国立卫生研究院卒中量表（National Institute of Health stroke scale，NIHSS）评分（OR=1.530，P=0.000，95%CI=1.229～1.904）、匹兹堡睡眠质量指数量表（Pittsburgh sleep quality index，PSQI）评分（OR=1.249，P=0.004，95%CI=1.073～1.454）、疼痛评分（visual analogue scale，VAS）（OR=1.839，P=0.018，95%CI=1.111～3.045）、收入（OR=6.364，P=0.007，95%CI=1.670～24.249）、照护者（OR=5.269，P=0.015，95%CI=1.384～20.058）是康复阶段脑卒中患者抑郁发生的独立危险因素。结论：脑卒中患者在康复阶段，疼痛程度越严重，NIHSS与PSQI评分越高，收入不足并且由职业陪护照顾时，越容易发生脑卒中后抑郁。

Abstract:

Objective：To investigate the incidence rate of post-stroke depression（PSD） in rehabilitation stage and related risk factors，as well as the symptoms of PSD which should be taken seriously in this stage. Methods：A cross-sectional survey was performed among 126 patients with stroke who were treated in Department of Rehabilitation Medicine in two grade A tertiary hospitals from March 2017 to January 2018. The Self-rating depression scale was used to evaluate the symptoms of depression，and related influencing factors were analyzed. Results：The univariate and multivariate analyses showed that National Institute of Health stroke scale（NIHSS） score[odds ratio（OR）=1.530，95% confidence interval（CI）＝1.229-1.904，P=0.000]，Pittsburgh sleep quality index（PSQI） score（OR=1.249，95%CI=1.073 to 1.454，P=0.004），Visual Analogue Scale（VAS） score（OR=1.839，95%CI=1.111 to 3.045，P=0.018），income（OR=6.364，95%CI=1.670 to 24.249，P=0.007），and caregiver（OR=5.269，95%CI=1.384 to 20.058，P=0.015） were independent risk factors for depression in patients with stroke in rehabilitation stage. Conclusion：The patients with stroke who have higher NIHSS，PSQI，and VAS scores and a lower level of income and are taken care of by professional caregivers in rehabilitation phase are more likely to de－velop PSD.