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短暂性脑缺血发作和脑卒中患者的情绪症状和生活质量的急性和长期损害。

Acute and long-term impairments regarding emotional symptoms and quality of life in patients suffering from transient ischemic attack and stroke.

机构信息

Department of Neurology, University of Leipzig, Leipzig, Germany.

Department of Neurology, Carl-von-Basedow-Klinikum Saalekreis, Merseburg, Germany.

出版信息

Neurol Res. 2021 May;43(5):396-405. doi: 10.1080/01616412.2020.1866370. Epub 2021 Jan 22.

DOI:10.1080/01616412.2020.1866370
PMID:33478369
Abstract

: Ischemic stroke (IS) is often associated with long-lasting physical deficits, linked to emotional symptoms (ES) and lowered quality of life (QoL). However, recent observations raised doubts regarding the traditional perspective of solely impairment-driven ES. In fact, anxiety and depression were also reported after transient ischemic attack (TIA) with a per definition absence of infarction and thus lacking physical deficits. This study follows the hypothesis that TIA patients might exhibit non-physical symptoms affecting individual QoL. In a prospective single-center observational study, IS patients (n = 73) were compared with TIA patients (n = 24) regarding their neurological deficit, ES and QoL, whereas the latter were evaluated by the Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Heath Survey (SF-36). Assessments were conducted six times within a one-year follow-up period. Overall, anxiety and depression decreased over time, while anxiety decreased more substantially. TIA patients showed similar levels of anxiety and depression when compared to IS patients. ES were detectable very early after the event and remained throughout the follow-up period in both groups. ES were associated with an impaired QoL including non-functional dimensions, while the strongest interrelations were observed for TIA patients, emphasizing interrelations between QoL and anxiety. This study indicates that ES after TIA are comparable to the emotional burden after IS. ES after TIA were associated with QoL, pointing out their crucial role for individual well-being. Although confirmation in larger studies is necessary, these data underpin the need for early clinical awareness regarding non-physical symptoms in TIA patients.

摘要

: 缺血性脑卒中(IS)常伴有持久的身体功能障碍,与情绪症状(ES)和生活质量(QoL)降低相关。然而,最近的观察结果对传统的仅由损伤驱动的 ES 观点提出了质疑。事实上,短暂性脑缺血发作(TIA)后也有焦虑和抑郁的报道,而 TIA 从定义上是没有梗死的,因此没有身体功能障碍。本研究遵循这样一个假设,即 TIA 患者可能会表现出影响个体 QoL 的非身体症状。在一项前瞻性单中心观察性研究中,IS 患者(n=73)与 TIA 患者(n=24)进行了比较,比较内容包括神经功能缺损、ES 和 QoL,后者采用医院焦虑抑郁量表(HADS)和健康调查简表 36 项(SF-36)进行评估。在一年的随访期间共进行了 6 次评估。总的来说,焦虑和抑郁随着时间的推移而下降,而焦虑的下降更为明显。与 IS 患者相比,TIA 患者的焦虑和抑郁水平相似。ES 在事件发生后很快就能被检测到,并在两组患者的整个随访期间都存在。ES 与 QoL 受损有关,包括非功能维度,而 TIA 患者的相关性最强,强调了 QoL 和焦虑之间的相互关系。本研究表明,TIA 后的 ES 与 IS 后的情绪负担相当。TIA 后的 ES 与 QoL 相关,表明它们对个体幸福感的重要作用。尽管还需要更大规模的研究来证实,但这些数据支持了在 TIA 患者中早期临床关注非身体症状的必要性。

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