Zhongguo cuzhong zazhi (Jul 2023)

伴前庭症状的急性轻型卒中患者6个月焦虑抑郁状态影响因素研究 Influencing Factors of Anxiety and Depression State at 6 months after Stroke in Acute Mild Stroke Patients with Vestibular Symptoms

  • 王琰，李佳树，方瑞乐，刘改芬，鞠奕

DOI
https://doi.org/10.3969/j.issn.1673-5765.2023.07.007
Journal volume & issue
Vol. 18, no. 7
pp. 787 – 792

Abstract

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目的 探索性研究伴前庭症状的急性轻型卒中患者卒中后6个月焦虑抑郁状态的危险因素及神经功能恢复情况。 方法 前瞻性连续收集2020年9月—2022年9月首都医科大学附属北京天坛医院神经内科住院患者中伴发前庭症状的急性轻型卒中患者的人口学信息、卒中危险因素、发病前mRS评分、入院时NIHSS评分、卒中类型和部位。评估住院期间及卒中后6个月HAMA和HAMD评分。根据卒中后6个月HAMA和HAMD评估结果将患者分为焦虑抑郁组和非焦虑抑郁组，采用二元logistic回归分析影响患者卒中后6个月焦虑抑郁状态的危险因素，同时随访mRS以评估神经功能恢复情况。 结果 共纳入患者230例，平均年龄（56.2±11.9）岁，全部患者发病6个月均预后良好（mRS评分<2分）。卒中后6个月时30例患者（13.0%）存在焦虑和（或）抑郁状态。二元logistic回归分析结果显示，住院期存在焦虑和（或）抑郁状态（OR 3.734，95%CI 1.659～8.400，P=0.001）是卒中后6个月存在焦虑和（或）抑郁状态的危险因素。 结论 伴前庭症状的急性轻型卒中患者整体神经功能预后良好，住院期间存在焦虑和（或）抑郁状态的患者更易在卒中后6个月继发焦虑和（或）抑郁状态。 Abstract: Objective To explore the risk factors and neurological recovery of anxiety and depression at 6 months after stroke in acute mild stroke patients with vestibular symptoms. Methods This prospective study continuously enrolled inpatients with acute mild stroke with vestibular symptoms in the Department of Neurology of Beijing Tiantan Hospital, Capital Medical University from September 2020 to September 2022. Demographic information, stroke risk factors, pre-stroke mRS Score, NIHSS score, stroke type and location were collected. HAMA and HAMD scores were assessed during hospitalization and 6 months after stroke. Divided the patients into anxiety-depression group and non-anxiety-depression group according to the HAMA and HAMD scores 6 months after stroke. To assess neurological recovery (by follow up mRS) and the risk factors of anxiety and depression 6 months after stroke by binary logistic regression. Results A total of 230 patients were included, with an average age of 56.2±11.9 years old, all patients had good prognosis (mRS score<2). At 6 months after stroke, 30 patients (13.0%) had anxiety and/or depression. The binary logistic regression analysis showed that the presence of anxiety and/or depression during hospitalization (OR 3.734, 95%CI 1.659-8.400, P=0.001) was a risk factor for anxiety and/or depression at 6 months after stroke. Conclusions Although the overall neurological prognosis of acute mild stroke patients with vestibular symptoms was good, patients with anxiety and/or depression during hospitalization are more likely to develop anxiety and/or depression 6 months after stroke.

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