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目的探讨社会心理因素、行为人格特征、情感障碍及生活相关事件对脑梗死患者早期智能障碍的影响。方法178例脑梗死患者(男134例,女44例),按入院顺序分为智能障碍组(98例),非智能障碍组(80例);对照组87例,对其应用A型性格问卷、艾森克个性问卷、抑郁自评量表及生活事件量表进行心理学检查,对比分析其智能障碍的发生与患者的性格特点、个性特征、情感障碍及负性生活事件的关系。结果智能障碍有98例,其中轻度49例,中度23例,重度26例。智能障碍组、非智能障碍组、对照组3组A型行为比较差异具有极显著性意义χ21=6.76,χ22=20.16,P<0.001;EPQ评定结果,神经质偏高和精神不稳定患者,智能障碍组较其他两组多χ21=23.56,χ22=34.49,P<0.001;有智能障碍者其焦虑情感及抑郁情感的发生均较其他两组高,χ21=21.904,χ22=88.5337,P<0.001。经历过负性生活事件者,发生智能障碍者比例较高,χ21=8.248,χ22=114.409,P<0.001。结论A型行为是脑梗死的易感行为,对脑梗死后的智能障碍的产生有影响。精神质的个性和不稳定情绪是脑梗死患者的主要情绪特征,与脑梗死后智能障碍的发生有关。血管性痴呆患者的情感障碍较一般脑梗死患者更加严重,可能与肢体瘫痪有关。负性生活事件的刺激对脑梗死后智能障碍的发生影响也很大。
Objective To investigate the impact of social psychological factors, personality traits, affective disorders and life-related events on early mental retardation in patients with cerebral infarction. Methods One hundred and seventy-eight patients with cerebral infarction (134 males and 44 females) were divided into four groups according to admission sequence: mental retardation group (n = 98) and non-mental retardation group (n = 80) , Eysenck’s Personality Questionnaire, Self-rating Depression Scale and Life Events Scale to compare the incidence of mental retardation with the personality traits, personality traits, affective disorders and negative life events. Results There were 98 cases of mental retardation, including 49 cases of mild, 23 cases of moderate and 26 cases of severe. There were significant differences in the behavior of type A in the three groups (χ21 = 6.76, χ22 = 20.16, P <0.001) between the group of mental retardation, the group of non-mental retardation and the control group. The scores of EPQ, neuroticism and mental instability Compared with the other two groups, there were more χ21 = 23.56, χ22 = 34.49, P <0.001; anxiety and depression in those with mental disorders were higher than the other two groups, χ21 = 21.904, χ22 = 88.5337, P <0.001. Experienced negative life events, a higher proportion of persons with intellectual disabilities, χ21 = 8.248, χ22 = 114.409, P <0.001. Conclusion A-type behavior is a predisposing behavior of cerebral infarction, which has an impact on the development of mental retardation after cerebral infarction. Psychotic personality and instability are the main emotional characteristics of patients with cerebral infarction, and cerebral infarction related to the occurrence of mental retardation. Affective disorder in patients with vascular dementia is more serious than the general cerebral infarction patients may be related to limb paralysis. Negative life events to stimulate the cerebral infarction after the impact of mental retardation is also great.