Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2010 May;19(3):184-189. doi: 10.1016/j.jstrokecerebrovasdis.2009.04.002.
Poststroke depression is one of the most frequent and important complications of stroke. Although many studies of depression after stroke have been reported, clinical association between the risk of depression after stroke and the lesion location remains unclear. The presence of depression after stroke reportedly confers a poor prognosis; however, early recognition of depressive symptoms may improve outcomes. We examined the relation between lesion location and presence of depressive symptoms 1 month after ischemic stroke, with a view toward early management of depressive symptoms.
In all, 134 consecutive patients with ischemic stroke were followed up to determine whether depression was present 1 month after stroke onset. Depressive symptoms were assessed by means of the Zung Self-rating Depression Scale. The lesion location was determined on magnetic resonance or computed tomography images.
The incidence of depressive symptoms 1 month after stroke onset was 34.3%. Backward stepwise logistic regression analysis showed hypertension, education, and the presence of a left lenticulocapsular infarct, in particular, to be independent predictors of depressive symptoms.
Patients with ischemic stroke, particularly in the left lenticulocapsular area, should be carefully evaluated for early detection and treatment of depressive symptoms, which may greatly influence outcome.
脑卒中后抑郁是脑卒中最常见和最重要的并发症之一。尽管已经有许多关于脑卒中后抑郁的研究，但脑卒中后抑郁的风险与病变部位之间的临床关联仍不清楚。脑卒中后出现抑郁据报道会带来不良预后；然而，早期识别抑郁症状可能会改善预后。我们研究了缺血性脑卒中后 1 个月时病变部位与抑郁症状之间的关系，以期早期管理抑郁症状。
共随访 134 例连续缺血性脑卒中患者，以确定脑卒中发作后 1 个月时是否存在抑郁。采用zung 自评抑郁量表评估抑郁症状。根据磁共振或计算机断层扫描图像确定病变部位。
脑卒中发作后 1 个月时抑郁症状的发生率为 34.3%。向后逐步逻辑回归分析显示，高血压、教育程度和左侧豆纹状核-壳核梗死的存在是抑郁症状的独立预测因素。
缺血性脑卒中患者，特别是左侧豆纹状核-壳核区域的患者，应仔细评估是否存在抑郁症状，以便早期发现和治疗，这可能会对预后产生重大影响。
