缺血性脑卒中后抑郁与脑白质疏松关系的初步研究

被引：17

作者：

钱俊枫

张志珺

钱方媛

杨玲俐

栾军祥

机构：

[1] 东南大学附属中大医院神经内科

来源：

中华神经医学杂志 | 2013年 / 12卷 / 10期

关键词：

脑卒中后抑郁; 脑白质疏松; 年龄相关的白质改变; 深部脑白质高信号;

D O I：

暂无

中图分类号：

R749.13 [];

学科分类号：

摘要：

目的初步探讨缺血性脑卒中急性期抑郁发生与脑白质疏松的关系。方法对东南大学附属中大医院神经内科自2007年6月至2011年3月收治的168例缺血性脑卒中急性期患者入院后均行头颅磁共振检查。在脑卒中发病14 d参照美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)诊断标准进行脑卒中后抑郁的诊断,其中60例(35.7%)患者发生脑卒中后抑郁(脑卒中后抑郁组),剩余患者中随机选取年龄与性别相匹配的60例脑卒中后非抑郁患者纳入脑卒中后非抑郁组。对2组患者采用Fazekas评分方法和年龄相关的白质改变(ARWMC)量表评估脑白质疏松的部位及严重程度,并且依据各变量在单因素分析中的检验水平(P<0.05)及临床意义筛选进入多因素Logistic回归分析中以探讨脑卒中后抑郁的危险因素。结果脑卒中后抑郁组深部脑白质高信号(DWMHs)评分和额叶区ARWMC评分明显高于脑卒中后非抑郁组,差异有统计学意义(P<0.05)。2组间脑室旁白质高信号(PVWMHs)及顶枕区、颞区、幕下区、基底节区ARWMC评分比较差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,DWMHs是缺血性脑卒中急性期抑郁发生的独立危险因素(OR:1.740,95%CI:1.194～2.536,P=0.004)。结论严重的深部脑白质疏松可能增加缺血性脑卒中急性期抑郁发生的易患性。

引用

页码：1043 / 1049

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