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汉密尔顿抑郁量表(17 项)在 2 周时的评分与缺血性脑卒中患者 1 年时的不良预后相关。

Factors of Hamilton Depression Rating Scale (17 items) at 2 weeks correlated with poor outcome at 1 year in patients with ischemic stroke.

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Dongcheng District, Beijing, 100050, China,

出版信息

Neurol Sci. 2014 Feb;35(2):171-7. doi: 10.1007/s10072-013-1464-z. Epub 2013 May 29.

Abstract

There was fewer paper about the relation between the Hamilton Depression Rating Scale (17 Items, HDRS-17) factors and stroke outcomes. Our aim was to investigate the influence of total score and factors of HDRS-17 on outcome of ischemic stroke at 1 year. A total of 1,953 patients with acute ischemic stroke were enrolled into a multicentered and prospective cohort study. The HDRS-17 was used to assess symptoms at 2 weeks after ischemic stroke. The Modified Ranking Scale (mRS) scores of 3-6 points and 0-2 points were regarded as poor outcome and benign outcome, respectively. At 1 year, 1,753 (89.8 %) patients had mRS score data. After adjusting for the confounders, patients with a total HDRS-17 score of ≥ 8 had a worse outcome at 1 year (OR = 1.62, 95 % CI 1.18-2.23). Symptoms of suicide (OR = 1.89, 95 % CI 1.27-2.83), decreased or loss of interest of work (OR = 1.89, 95 % CI 1.38-2.58), retardation (OR = 1.74, 95 % CI 1.27-2.38), psychic anxiety (OR = 1.72, 95 % CI 1.26-2.34), and agitation (OR = 1.61, 95 % CI 1.08-2.40) increased the risks for poor outcome by >60 %, respectively. Depressed mood, somatic anxiety, somatic symptoms-gastrointestinal, and early insomnia also increased the risk for poor outcome by nearly 50 %, respectively. A total HDRS-17 score of ≥ 8, and suicide, decreased or loss of interest of work, anxiety, agitation, retardation, depressed mood, somatic anxiety, somatic symptoms-gastrointestinal, and early insomnia of the HDRS-17 factors at 2 weeks after ischemic stroke increase the risk for poor outcome at 1 year.

摘要

关于汉密尔顿抑郁量表(17 项,HDRS-17)因子与中风结局之间的关系,相关文献较少。我们的目的是研究总分和 HDRS-17 因子对缺血性中风 1 年结局的影响。共纳入 1953 例急性缺血性中风患者进行多中心前瞻性队列研究。HDRS-17 用于评估中风后 2 周的症状。改良 Rankin 量表(mRS)评分 3-6 分和 0-2 分分别视为预后不良和预后良好。1 年后,1753 例(89.8%)患者有 mRS 评分数据。在调整混杂因素后,HDRS-17 总分≥8 分的患者 1 年预后较差(OR=1.62,95%CI 1.18-2.23)。自杀症状(OR=1.89,95%CI 1.27-2.83)、对工作兴趣减退或丧失(OR=1.89,95%CI 1.38-2.58)、迟缓(OR=1.74,95%CI 1.27-2.38)、精神焦虑(OR=1.72,95%CI 1.26-2.34)和激越(OR=1.61,95%CI 1.08-2.40)的症状使不良预后的风险分别增加超过 60%。心境低落、躯体焦虑、胃肠躯体症状和早醒也使不良预后的风险分别增加近 50%。中风后 2 周时 HDRS-17 的总分≥8 分以及自杀、对工作兴趣减退或丧失、焦虑、激越、迟缓、心境低落、躯体焦虑、胃肠躯体症状和早醒等因子与 1 年后的不良预后风险增加有关。

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