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中国人民解放军总医院
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解放军总医院医学创新研究部、国家老年疾病临床医学研究中心(解放军总医院)、解放军总医院第六医学中心心血管病医学部
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
主 编 范利
执行主编 陈韵岱
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
章梦琦,丁佳豪,郝明霞,陈晓,龙丽婷,田荣燊,张爽,苑杰.不同性别急性缺血性卒中后抑郁患者的临床异质性[J].中华老年多器官疾病杂志,2023,22(1):47~52
不同性别急性缺血性卒中后抑郁患者的临床异质性
Clinical heterogeneity of depression after acute ischemic stroke between genders
投稿时间:2022-08-16  
DOI:10.11915/j.issn.1671-5403.2023.01.009
中文关键词:  性别  卒中后抑郁  临床异质性  汉密尔顿抑郁量表
英文关键词:gender  post-stroke depression  clinical heterogeneity  Hamilton Depression Scale This work was supported by the Research Projects in Medical Sciences of Hebei Province 2020
基金项目:河北省2020年度医学科学研究课题(20201216)
作者单位E-mail
章梦琦 华北理工大学心理与精神卫生学院,河北 唐山 063000 tsphyj@126.comclinical 
丁佳豪 华北理工大学心理与精神卫生学院,河北 唐山 063000 tsphyj@126.comclinical 
郝明霞 华北理工大学心理与精神卫生学院,河北 唐山 063000 tsphyj@126.comclinical 
陈晓 华北理工大学心理与精神卫生学院,河北 唐山 063000 tsphyj@126.comclinical 
龙丽婷 华北理工大学心理与精神卫生学院,河北 唐山 063000 tsphyj@126.comclinical 
田荣燊 华北理工大学附属医院,河北 唐山 063000 tsphyj@126.comclinical 
张爽 华北理工大学附属医院,河北 唐山 063000 tsphyj@126.comclinical 
苑杰 华北理工大学精神卫生研究所,河北 唐山 063000 tsphyj@126.comclinical 
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中文摘要:
      目的 探讨不同性别卒中后抑郁(PSD)患者临床症状的异质性。方法 选取2020年12月至2022年2月于华北理工大学附属医院501例急性缺血性脑卒中患者为研究对象,收集其一般临床资料,入院24h内进行美国国立卫生研究院脑卒中评分(NIHSS)、日常生活活动能力(ADL)评分,入院1周后采用24项汉密尔顿抑郁量表(HAMD-24)评估患者抑郁情绪。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、非参数检验及χ2检验。结果 501例脑卒中患者中,PSD患者173例,其中男性96例,女性77例。男性PSD患者NIHSS评分显著高于女性[(5.44±4.25)和(3.97±5.63)分;P<0.01],男性PSD患者ADL评分显著低于女性[(68.07±20.10)和(79.35±21.69)分;P<0.01]。HAMD-24单项症状比较,男性PSD患者抑郁情绪得分低于女性PSD患者[1.00(0.00,2.00)和1.00(1.00,2.00)分;P<0.05],男性PSD患者的工作和兴趣[0.00(0.00,1.00)和0.00(0.00,0.00)分]、迟缓[0.00(0.00,1.00)和0.00(0.00,0.00)分]、激越[0.50(0.00,2.00)和0.00(0.00,1.00)分]、全身症状[2.00(1.00,3.00)和1.00(0.00,2.00)分]、体质量减轻[1.00(0.00,2.00)和0.00(0.00,1.00)分]、自知力[0.00(0.00,1.00)和0.00(0.00,0.00)分]得分均高于女性PSD患者(均P<0.05)。HAMD-24各因子比较,男性PSD患者体质量减轻[1.00(0.00,2.00)和0.00(0.00,1.00)分]、绝望感因子[1.00(0.00,2.00)和0.00(0.00,2.00)分]均高于女性PSD患者(均P<0.05)。不同性别PSD患者症状严重系数较高的因子均为焦虑/躯体化和睡眠障碍。结论 不同性别PSD患者临床症状存在异质性,临床工作中应针对不同性别脑卒中患者的临床症状予以鉴别。
英文摘要:
      Objective To explore the heterogeneity of clinical symptoms between genders in patients with post-stroke depression (PSD). Methods A total of 501 patients with acute ischemic stroke in Affiliated Hospital of North China University of Science and Technology from December 2020 to February 2022 were selected as the subjects. Their general clinical data were collected, and they were evaluated with National Institutes of Health Stroke Scale (NIHSS) and the activities of Daily Living (ADL) scale within 24 hours after admission. One week after admission, the depressive mood of patients was evaluated using the 24-item Hamilton Depression Scale (HAMD-24). SPSS 26.0 was used for statistical analysis. Depending on data type, comparison between groups was performed using t test, non-parametric test or χ2 test. Results Among 501 patients with stroke, 173 (96 men and 77 women) had PSD. PSD men scored significantly higher than women [(5.44±4.25) vs (3.97±5.63) points; P<0.01] on NIHSS and significantly lower [(68.07±20.10) vs (79.35±21.69) points; P<0.01] on ADL scale. With the single symptom of HAMD-24, PSD men scored significantly lower than PSD women in depression [1.00(0.00,2.00) vs 1.00(1.00,2.00) points;P<0.05], but significantly higher in work and interest [0.00(0.00,1.00) vs 0.00(0.00,0.00) points], tardiness [0.00(0.00,1.00) vs 0.00(0.00,0.00) points], agitation [0.50(0.00,2.00) vs 0.00(0.00,1.00) points], systemic symptoms [2.00(1.00,3.00) vs 1.00(0.00,2.00) points], weight loss [1.00(0.00,2.00) vs 0.00(0.00,1.00) points] and self-awareness [0.00(0.00,1.00) vs 0.00(0.00,0.00) points] ( P<0.05 for all). Among HAMD-24 symptoms, the scores for weight loss [1.00(0.00,2.00) vs 0.00(0.00,1.00) points] and for despair [1.00(0.00,2.00) vs 0.00(0.00,2.00) points] were higher in PSD men than in PSD women (P<0.05 for both). Anxiety, somatization, and sleep disorders were the factors with higher symptom severity coefficients in PSD patients of both genders. Conclusion The clinical symptoms of PSD patients are heterogeneous between genders. Attention should be paid to the gender differences in symptoms among stroke patients of in clinical practice.
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