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目的探讨脑微出血(CMB)与腔隙性脑梗死(LI)患者卒中后抑郁的相关性。方法选择腔隙性脑梗死患者216例,进行老年抑郁量表(GDS)评测,≥5分为存在抑郁,分为抑郁组和无抑郁组。记录两组CMB总数量及脑叶CMB、深部CMB、幕下CMB及左右半球CMB数量,分析两组CMB数量与部位、人口学资料、临床资料及影像学资料的关系。结果两组在脑叶CMB及左半球CMB、女性、美国国立卫生研究院卒中量表(NIHSS)评分、脑白质病变(WML)、深部LI及左半球LI等方面比较差异有统计学意义(P<0.05)。多因素分析提示脑叶CMB是卒中后抑郁(PSD)的独立危险因素(OR=5.843,P=0.040)。结论脑叶CMB及左半球CMB为PSD危险因素,其他危险因素包括女性、较严重的神经功能缺损、脑白质病变、LI特别是深部及左半球LI。
Objective To investigate the relationship between cerebral micro-hemorrhage (CMB) and post-stroke depression in patients with lacunar infarction (LI). Methods Two hundred and sixty-six patients with lacunar infarction were selected and evaluated by the Depression Scale of Geriatric Depression (GDS). Five or more patients were divided into depression group and depression group. The total number of CMB, CMB in deep lobe, CMB in lower lobe, CMB in lower lobe and CMB in left hemisphere were recorded. The relationship between CMB quantity and location, demography, clinical data and imaging data were analyzed. Results There was significant difference between CMB of left lobe and CMB of left lobe, female, NIHSS score, white matter lesions (WML), deep LI and LI of left hemisphere in both groups (P <0.05). Multivariate analysis suggested that brain CMB was an independent risk factor for post-stroke depression (OR = 5.843, P = 0.040). Conclusions Cerebral lobe CMB and left hemisphere CMB are PSD risk factors. Other risk factors include female, severe neurological deficit, white matter lesion, LI especially deep and left hemisphere LI.