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目的:探讨缺血性脑卒中后早期CT值预后抑郁指数及神经功能的相关性及临床意义。方法:选取2014年6月-2016年3月因缺血性脑卒中于我院住院的患者共89例,根据预后是否发生抑郁分为抑郁组(PSD)和非抑郁组,记录所有患者卒中部位的CT值,采用抑郁自评量表(SDS)和神经功能缺损评分(NDS)评价患者的神经功能,采用SPSS 24.0对其结果进行相关分析。结果:PSD组和非PSD组患者病变部位比例比较差异无统计学意义,PSD组患者卒中后2w、1m和3m的抑郁指数显著高于非PSD组(t=7.083,10.369,13.866;P<0.05),PSD组患者在卒中后1m和3m的HAMD评分显著高于非PSD组(t=7.758,11.027;P<0.05),其中PSD组的平均CT值为(23.4±2.5)HU,非PSD组的CT值为(28.4±2.8)HU,PSD组显著低于非PSD组,差异具有统计学意义(t=-8.717,P<0.05),卒中后3个月PSD组的NIHSS显著高于非PSD组(t=5.262,P<0.05)而ADL分低于非PSD组(t=-7.330,P<0.05),缺血性脑卒中早期CT值和抑郁指数显著的负相关(r=-0.477,P=0.016),与HAMD评分存在显著的负相关(r=-0.526,P=0.004),与NIHSS评分存在显著的负相关(r=-0.487,P=0.001),与ADL评分存在显著的正相关(r=0.503,P<0.001)。结论:缺血性脑卒中早期的CT值与抑郁指数和神经功能呈负相关,对卒中后PSD的发生具有一定的预测作用。
Objective: To investigate the correlation between the prognostic value of depression and neurological function in patients with early post-ischemic stroke and its clinical significance. Methods: A total of 89 hospitalized patients with ischemic stroke in our hospital from June 2014 to March 2016 were selected and divided into depression group (PSD) and non-depression group according to whether depression occurred or not. All stroke patients were recorded The neurological function of patients was assessed by Self-Rating Depression Scale (SDS) and Neurological Deficiency Index (NDS). The correlations were analyzed by SPSS 24.0. Results: There was no significant difference in the proportion of lesions between PSD group and non-PSD group. The depression index of PSD group at 2w, 1m and 3m after stroke was significantly higher than that of non-PSD group (t = 7.083,10.369,13.866; P <0.05 ). The HAMD scores of PSD patients at 1 and 3 m after stroke were significantly higher than those of non-PSD patients (t = 7.758 and 11.027; P <0.05). The average CT value of PSD patients was (23.4 ± 2.5) HU, (28.4 ± 2.8) HU in PSD group was significantly lower than that in non-PSD group (t = -8.717, P <0.05). NIHSS in PSD group at 3 months after stroke was significantly higher than that in non-PSD (T = 5.262, P <0.05) and ADL score was lower than non-PSD group (t = -7.330, P <0.05). There was a significant negative correlation between CT value and depression index in the early stage of ischemic stroke (r = -0.477, (R = -0.526, P = 0.004). There was a significant negative correlation with NIHSS score (r = -0.487, P = 0.001), and there was a significant positive correlation with ADL score (R = 0.503, P <0.001). Conclusion: The CT value of ischemic stroke in the early stage is negatively correlated with depression index and neurological function, which may predict the occurrence of PSD after stroke.