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脑损伤部位和病前生活方式与卒中后抑郁之间关系研究
其他题名The study of cerebral lesion location and premorbid lifestyle relation with post-stroke depression(PSD)
万继峰
学位类型同等学力硕士
2013
学位授予单位中国科学院研究生院
学位授予地点北京
学位专业心理学
关键词脑卒中 卒中后抑郁 脑损伤的部位 生活方式量表 保护作用
摘要摘要 目的:探讨脑卒中患者脑损伤的部位和病前生活方式与卒中后抑郁(post-stroke depression PSD)之间的关系,研究结果可以用来指导临床医师对脑卒中患者是否发生PSD进行早期预测和临床干预,减少PSD的发生。 方法:所有患者均为2012年8月至2013年3月在煤炭总医院神经内科就诊的首次发病的脑卒中病人,均经头颅CT或MRI确诊为颅内一个部位的病变,并在入院2周时采用Zung自评量表对患者进行测评,根据量表得分情况将患者分为抑郁组和非抑郁组,共116例患者,调查项目包括性别,年龄,婚姻情况,文化程度,经济收入,合并其他疾病情况,卒中类型,脑卒中后脑损伤的部位及生活方式量表等。选用SPSS17.0统计软件进行数据分析。 结果:PSD的发生率为32.8%,其中,轻度抑郁16例(13.8%),中度抑郁18例(15.5%),重度抑郁4例(3.5%);抑郁组和非抑郁组在年龄、文化程度、配偶是否在身边、脑卒中的类型、是否合并有高血压病、糖尿病、高脂血症及两种以上疾病之间经检验差异无显著意义(P>0.05);在性别方面,女性较男性更易抑郁(χ2=4.465,P=0.035);在个人收入方面,个人收入越低,越容易发生抑郁(χ2=85.398,P<0.001);PSD的发生与脑卒中后脑损伤的部位之间关系密切,损伤部位发生在左侧者易发生抑郁(χ2=14.208,P=0.014),尤其是左侧基底节区和左侧皮质部位的脑损伤易发生抑郁;对生活方式与PSD之间的相关分析表明,生活方式对PSD有保护作用;回归分析结果发现,患者的性别、个人收入、脑卒中后脑损伤的部位,生活方式中的社会交往、睡眠及卫生三因子对是否发生卒中后抑郁有预测作用。 结论:1,脑卒中患者脑损伤的部位发生在左侧者易发生PSD(χ2=14.208,P=0.014),尤其是左侧基底节区和左侧皮质的脑损伤易发生抑郁; 2,卒中后抑郁(PSD)组和非抑郁(non-PSD)组相比,女性较男性更易抑郁(χ2=4.465,P=0.035);个人收入越低,越容易发生抑郁(χ2=85.398,P<0.001);3,PSD组和non-PSD组在年龄、文化程度、配偶是否在身边、脑卒中的类型、是否合并高血压病、糖尿病、高脂血症及合并两种以上疾病之间,差异无显著性意义(P>0.05);4,相关分析显示病前生活方式对PSD有保护作用;5,对PSD的各种相关因素进行回归分析结果发现,患者的性别、个人收入、脑卒中的部位,生活方式中的社会交往、睡眠及卫生三因子对是否发生PSD有预测作用。
其他摘要Abstract Objective: post-stroke depression (post-stroke depression PSD) is one of the common complications of the stroke,it hinders the recovery of neural function in stroke patients, reducing the quality of life of patients,more and more doctor pay close attention to PSD, however, the relationship of PSD and location of cerebral lesion is not clear,at the same time,whether the lifestyle has a protective effect on PSD is still not clear.The results can be used to guide doctor to predict stroke patients whether to supervene PSD,and reduce the incidence of PSD. Methods: All patients were from the neurology department of the Coal General Hospital during August 2012 to March 2013,the patients of stroke were checked by CT or MRI, and were diagnosed one lesion location within three days,according to the Zung self-rating scale score,patients were divided into post-stroke depression group and non-post-stroke depression group,selected the total of 116 patients after two weeks.The survey general condition of patients,include gender,age,marital status,education level,personal income,combined with other diseases,stroke type,location of cerebral lesion and lifescale.SPSS17.0 statistical software was used to analyze the data. Results:The mobidity rate of PSD was 32.8%,of which,16 cases(13.8%) were mild depression,18 cases (15.5%) were moderate depression, four cases (3.5%) were severe depression.,PSD group and non-PSD group were showed no significant in age,education level and whether the spouse around. The investigation was founded that women were more likely to depression than men (χ2=4.465, P=0.035),at the same time,PSD was associated with personal income,the lower personal income,the more depression prone to.PSD was not associated with the type of stroke and accompany with hypertension, diabetes, hyperlipidemia, over two or more disease.Lesion location on the left side was prone to depression(χ2=14.208, P=0.014),further analysis showed that lesion location on the left was apt to depression than on the right, the basal ganglia part was more susceptible to depression than on other parts of the brain.Correlation analysis showed that PSD was significantly correlated with lifestyle of diet,sleep,social interaction,exercise,entertainment,health awareness and health, the higher of the score,the less prone to PSD,regression analysis found that the parts of the patient's gender,personal income,stroke lesion location,the lifestyle of social interaction, sleep and health may predict depression. Conclusion:1,Post-stroke depression group and non-depressed group were not significant in the side of age, spouse whether at his side and education level.2, Women were more likely prone to depression than men,and the lower personal income was more prone to depression.3,There were no significant effects between groups in the type of stroke, hypertension, diabetes, hyperlipidemia, over two or more diseases.4,There was significant in lesion location on the left side prone to depression,further analysis showed that there was no difference between the basal ganglia portion and the cortical portion,but the basal ganglia was easy depression than other parts of the brain.5,Regular diet,fine sleep,social interaction,active exercise,entertainment,health awareness and good health were not easily depression after his stroke,on the contrary,he was prone to depression.6,The various factors regression analysis was found that the patient's gender,personal income,the lesion location, the three part of lifestyle,include social interaction,sleep and health may predict whether depression. 
学科领域医学心理学
语种中文
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/20633
专题健康与遗传心理学研究室
作者单位中国科学院心理研究所
推荐引用方式
GB/T 7714
万继峰. 脑损伤部位和病前生活方式与卒中后抑郁之间关系研究[D]. 北京. 中国科学院研究生院,2013.
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