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目的:探讨不同时期出血性脑卒中后抑郁(Post-Stroke Depression,PSD)患者认知功能和生活质量的特征。方法:采用前瞻性队列研究,对57例PSD患者和91例非PSD(None PSD,NPSD)患者在基线期、6周和12周后分别进行临床神经功能缺损程度评分量表(China Stroke Scale,CSS)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,Mo CA)和Barthel指数(Barthel Index,BI)的评估。结果:基线期PSD和NPSD患者Mo CA总分[分别为(11.6±2.9)分、(11.2±3.1)分]和BI总分[分别为(45.6±8.3)分、(46.2±7.2)分],差异无统计学意义(P>0.05);治疗6周和12周后PSD组Mo CA总分[分别为(13.4±2.3)分、(18.2±3.2)分]和BI总分[分别为(63.8±6.5)分、(77.2±4.1)分]均低于NPSD组[分别为(15.8±2.8)分、(22.6±2.4)分;(72.2±7.5)分、(85.8±5.6)分],差异有统计学意义(P<0.000)。结论:在卒中的康复后期,PSD患者较NPSD患者认知功能障碍损害更严重,生活质量更差。推测认知功能是PSD患者长期预后的独立预测因素,可为PSD患者康复策略的制定提供帮助。
Objective: To investigate the cognitive function and quality of life of post-stroke depression (Post-Stroke Depression, PSD) in different periods. Methods: A prospective cohort study was conducted in 57 PSD patients and 91 non-PSD patients (NPSD) at baseline, 6 and 12 weeks after surgery to assess the severity of neurological deficits (China Stroke Scale, CSS), Hamilton Depression Scale (HAMD), Montreal Cognitive Assessment (MoCA) and Barthel Index (BI). RESULTS: The MoCA score [(11.6 ± 2.9) vs (11.2 ± 3.1)] and BI total score [(45.6 ± 8.3) and (46.2 ± 7.2) , Respectively. There was no significant difference between the two groups (P> 0.05). At 6 weeks and 12 weeks after treatment, the MoCA score [(13.4 ± 2.3) and (18.2 ± 3.2) 63.8 ± 6.5), (77.2 ± 4.1)] were significantly lower than those in the NPSD group [(15.8 ± 2.8) points, (22.6 ± 2.4) points, (72.2 ± 7.5) points, (85.8 ± 5.6) points, The difference was statistically significant (P <0.000). Conclusions: In the later stages of stroke, PSD patients have more severe cognitive impairment and worse quality of life than NPSD patients. It is speculated that cognitive function is an independent predictor of long-term prognosis in PSD patients, which may be helpful in the development of rehabilitation strategies for PSD patients.