新发脑梗死后患者认知损害及抑郁的发生情况研究
|
摘要
目的旨在探讨新发脑梗死后患者认知损害及抑郁的发生情况。方法选择2016年5月～2017年10月来我院就诊的新发脑梗死患者156例,采用汉密尔顿抑郁量表(HAMD)评价患者的抑郁症状,并将患者分为非抑郁组和抑郁组,采用蒙特利尔认知评估量表(MoCA)和简易精神状态评价量表(MMSE)评价患者认知功能水平,并根据MoCA评分结果将患者分为认知正常组、轻度认知损害组和重度认知损害组,评估脑梗死后患者抑郁和认知障碍的发生情况,并分析两者的相互关系。结果认知正常组、轻度认知损害组和重度认知损害组的MoCA、MMSE和HAMD评分差异有统计学意义(P<0.05),非抑郁组的MMSE各项评分皆高于抑郁组,差异有统计学意义(P<0.05)。认知损害与抑郁在定向、回忆能力及语言能力方面存在交互作用,且交互作用有统计学意义(P<0.05)。结论脑梗死后患者可能并发抑郁和认知功能障碍,两者之间存在一定的交互关系。
Objective To investigate the occurrence of cognitive impairment and depression in patients with new-onset cerebral infarction. Methods A total of 156 patients with new-onset cerebral infarction admitted in our hospital from May 2016 to October 2017 were enrolled. The Hamilton Depression Table(HAMD) was used to evaluate the depressive symptoms and the patients were divided into non-depression group and depression group. The Montreal Cognitive Assessment Scale(MoCA) and the Mini-Mental State Assessment Scale(MMSE) were used to evaluate the cognitive function of patients, and the patients were divided into cognitive normal group, mild cognitive impairment group and severe cognitive impairment group according to MoCA score. The incidence of depression and cognitive impairment in patients after cerebral infarction was assessed, and the relationship between the two groups was analyzed. Results The differences in MoCA, MMSE and HAMD scores between the cognitive normal group, mild cognitive impairment group and severe cognitive impairment group were statistically significant(P<0.05). The MMSE scores in the non-depressed group were higher than those in the depression group, and the difference was statistically significant(P<0.05). There was an interaction between cognitive impairment and depression in orientation, recall ability and language ability, and the difference in the interaction was statistically significant(P<0.05). Conclusion Patients with cerebral infarction may have depression and cognitive dysfunction, and there is a certain interaction between them.
Objective To investigate the occurrence of cognitive impairment and depression in patients with new-onset cerebral infarction. Methods A total of 156 patients with new-onset cerebral infarction admitted in our hospital from May 2016 to October 2017 were enrolled. The Hamilton Depression Table(HAMD) was used to evaluate the depressive symptoms and the patients were divided into non-depression group and depression group. The Montreal Cognitive Assessment Scale(MoCA) and the Mini-Mental State Assessment Scale(MMSE) were used to evaluate the cognitive function of patients, and the patients were divided into cognitive normal group, mild cognitive impairment group and severe cognitive impairment group according to MoCA score. The incidence of depression and cognitive impairment in patients after cerebral infarction was assessed, and the relationship between the two groups was analyzed. Results The differences in MoCA, MMSE and HAMD scores between the cognitive normal group, mild cognitive impairment group and severe cognitive impairment group were statistically significant(P<0.05). The MMSE scores in the non-depressed group were higher than those in the depression group, and the difference was statistically significant(P<0.05). There was an interaction between cognitive impairment and depression in orientation, recall ability and language ability, and the difference in the interaction was statistically significant(P<0.05). Conclusion Patients with cerebral infarction may have depression and cognitive dysfunction, and there is a certain interaction between them.
引文
[1]国家卫生计生委防治工程委员会.中国卒中流行报告2015[M].北京:中国协和医科大学出版社,2015.
[2]吴亚哲,陈伟伟.中国脑卒中流行概况[J].心脑血管病防治,2016,16(6):410-414.
[3]张薇,范宇威,高静,等.脑卒中流行病学调查相关文献复习[J].中国临床神经科学,2014,22(6):699-703.
[4]张钰,曾丽莉,刘建荣.脑卒中后早期抑郁发病率及影响因素分析[J].中国现代神经疾病杂志,2015,15(3):203-208.
[5]王惠婷,温清秀,陈细曲,等.老年脑卒中患者抑郁现状及影响因素分析[J].护理学报,2016,23(23):48-53.
[6] Taylor GH,Broomfield NM. Cognitive assessment and rehabilitation pathway for stroke(CAPS)[J]. Top Stroke Rehabil,2013,20(3):270-282.
[7] Hobson P,Meara J. Cognitive function and mortality in a community based elderly cohort of first ever stroke survivors and control subjects[J]. J Stroke Cerebrovasc Dis,2010,19(5):382-387.
[8]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[9]韩叶萍.蒙特梭利干预对脑卒中患者认知能力的影响[J].世界最新医学信息文摘,2018,18(12):32-34.
[10] Zhang FL,Guo ZN,Wu YH,et al. Prevalence of stroke and associated risk factors:a population based cross sectional study from northeast China[J]. BMJ Open,2017,7(9):e015758.
[11] Jinlei Li,Longde Wang,Baohua Chao,et al.Prevalence of stroke in China:An epidemiological study based on the national stroke screening survey[J]. Lancet,2015,386(S1):S49.
[12]段睿康,付剑亮.脑卒中后认知功能障碍[J].中国老年学杂志,2017,37(24):6272-6274.
[13]程蕊容,辛秀峰,刘章佩,等.卒中后认知障碍的研究进展[J].临床荟萃,2018,33(1):89-92.
[14]高春林,巫嘉陵.脑卒中后抑郁临床研究进展[J].中国现代神经疾病杂志,2017,17(4):249-253.
[15]赵红艳,王惠琴,徐玲芬,等.中青年脑卒中患者配偶抑郁现状及影响因素分析[J].护理与康复,2016,15(5):419-422.
[16]王芹,陶静,刘斐雯,等.脑卒中后认知功能障碍治疗概况[J].湖南中医杂志,2016,32(4):168-170.
[17] Goveas JS,Espeland MA,Woods NF,et al. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women:The women's health initiative memory study[J]. J Am Geriatr Soc,2011,59(1):57-66.
[18]刘永珍,尹静,赵翠竹,等.急性期首发脑卒中后抑郁状态与认知功能障碍的相关危险因素研究[J].中华老年心脑血管病杂志,2018,20(4):353-357.
[19]宋文明,李金秋,刘菊花,等.卒中后抑郁患者的认知功能与血浆同型半胱氨酸水平的临床研究[J].临床医学工程,2016,23(5):605-606.
[20]籍玉红.卒中后抑郁患者认知功能、同型半胱氨酸以及MTHFR基因多态性的相关研究[J].中国临床医生杂志,2015,43(5):47-51.
[21]何莉娜,颜志刚,孙景波.362例脑梗死患者证候与梗死后抑郁及认知障碍关系的研究[J].中国中医急症,2014,23(1):34-35.
[2]吴亚哲,陈伟伟.中国脑卒中流行概况[J].心脑血管病防治,2016,16(6):410-414.
[3]张薇,范宇威,高静,等.脑卒中流行病学调查相关文献复习[J].中国临床神经科学,2014,22(6):699-703.
[4]张钰,曾丽莉,刘建荣.脑卒中后早期抑郁发病率及影响因素分析[J].中国现代神经疾病杂志,2015,15(3):203-208.
[5]王惠婷,温清秀,陈细曲,等.老年脑卒中患者抑郁现状及影响因素分析[J].护理学报,2016,23(23):48-53.
[6] Taylor GH,Broomfield NM. Cognitive assessment and rehabilitation pathway for stroke(CAPS)[J]. Top Stroke Rehabil,2013,20(3):270-282.
[7] Hobson P,Meara J. Cognitive function and mortality in a community based elderly cohort of first ever stroke survivors and control subjects[J]. J Stroke Cerebrovasc Dis,2010,19(5):382-387.
[8]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点(1995)[J].临床和实验医学杂志,2013,12(7):559.
[9]韩叶萍.蒙特梭利干预对脑卒中患者认知能力的影响[J].世界最新医学信息文摘,2018,18(12):32-34.
[10] Zhang FL,Guo ZN,Wu YH,et al. Prevalence of stroke and associated risk factors:a population based cross sectional study from northeast China[J]. BMJ Open,2017,7(9):e015758.
[11] Jinlei Li,Longde Wang,Baohua Chao,et al.Prevalence of stroke in China:An epidemiological study based on the national stroke screening survey[J]. Lancet,2015,386(S1):S49.
[12]段睿康,付剑亮.脑卒中后认知功能障碍[J].中国老年学杂志,2017,37(24):6272-6274.
[13]程蕊容,辛秀峰,刘章佩,等.卒中后认知障碍的研究进展[J].临床荟萃,2018,33(1):89-92.
[14]高春林,巫嘉陵.脑卒中后抑郁临床研究进展[J].中国现代神经疾病杂志,2017,17(4):249-253.
[15]赵红艳,王惠琴,徐玲芬,等.中青年脑卒中患者配偶抑郁现状及影响因素分析[J].护理与康复,2016,15(5):419-422.
[16]王芹,陶静,刘斐雯,等.脑卒中后认知功能障碍治疗概况[J].湖南中医杂志,2016,32(4):168-170.
[17] Goveas JS,Espeland MA,Woods NF,et al. Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women:The women's health initiative memory study[J]. J Am Geriatr Soc,2011,59(1):57-66.
[18]刘永珍,尹静,赵翠竹,等.急性期首发脑卒中后抑郁状态与认知功能障碍的相关危险因素研究[J].中华老年心脑血管病杂志,2018,20(4):353-357.
[19]宋文明,李金秋,刘菊花,等.卒中后抑郁患者的认知功能与血浆同型半胱氨酸水平的临床研究[J].临床医学工程,2016,23(5):605-606.
[20]籍玉红.卒中后抑郁患者认知功能、同型半胱氨酸以及MTHFR基因多态性的相关研究[J].中国临床医生杂志,2015,43(5):47-51.
[21]何莉娜,颜志刚,孙景波.362例脑梗死患者证候与梗死后抑郁及认知障碍关系的研究[J].中国中医急症,2014,23(1):34-35.