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新冠疫情限制措施解除后中风后抑郁的风险因素

Risk Factors for Post-Stroke Depression Following the Lifting of COVID-19 Restrictions.

作者信息

Luo Shangyu, Hu Xueqin, Hong Yunjun, Gao Yunchun, Liu Xianglin, Peng Yu, Tong Xueqing, Zhang Xiaobo, Wen Jun

机构信息

Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde City, Hunan Province, People's Republic of China.

Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde City, Hunan Province, People's Republic of China.

出版信息

Int J Gen Med. 2024 Aug 13;17:3479-3491. doi: 10.2147/IJGM.S472339. eCollection 2024.

Abstract

PURPOSE

Research on post-stroke depression (PSD) following the lifting of coronavirus disease 2019 (COVID-19) restrictions remains sparse. This study aimed to investigate the factors associated with PSD after the easing of COVID-19 restriction measures.

PATIENTS AND METHODS

This cross-sectional study was conducted with 947 stroke patients (cerebral hemorrhage and cerebral infarction) meeting the inclusion criteria. Participants completed a demographic questionnaire and the Patient Health Questionnaire-9 (PHQ-9). Additionally, data were collected on C-reactive protein (CRP), homocysteine (Hcy), modified Rankin Scale (mRS), stroke site, National Institutes of Health Stroke Scale (NIHSS), thyroid-stimulating hormone (TSH), and the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. This study assessed correlations between these indices and PSD.

RESULTS

Stroke patients with a PHQ-9 score ≥5 were identified as having PSD, with a prevalence rate of 14.15%. No significant correlation was found between previous COVID-19 infection and PSD. However, multiple regression analysis revealed associations between PSD and the following factors: TSH (OR: 0.87, 95% CI: 0.76-1), CRP levels (OR: 1.01, 95% CI: 1-1.02), family history of stroke (OR: 4.25, 95% CI: 1.66-10.88), migraine history (OR: 8.63, 95% CI: 2.49-29.85), and shorter sleep duration (OR: 0.6, 95% CI: 0.51-0.71) (all 0.05).

CONCLUSION

CRP, family history of stroke, migraine, sleep duration, and TSH are identified as independent risk factors for PSD following the lifting of COVID-19 restrictions.

摘要

目的

关于2019冠状病毒病(COVID-19)限制措施解除后中风后抑郁症(PSD)的研究仍然很少。本研究旨在调查COVID-19限制措施放宽后与PSD相关的因素。

患者与方法

本横断面研究对947名符合纳入标准的中风患者(脑出血和脑梗死)进行。参与者完成了一份人口统计学问卷和患者健康问卷-9(PHQ-9)。此外,收集了以下数据:C反应蛋白(CRP)、同型半胱氨酸(Hcy)、改良Rankin量表(mRS)、中风部位、美国国立卫生研究院卒中量表(NIHSS)、促甲状腺激素(TSH)以及急性卒中治疗中ORG 10172试验(TOAST)分类。本研究评估了这些指标与PSD之间的相关性。

结果

PHQ-9评分≥5的中风患者被确定为患有PSD,患病率为14.15%。未发现既往COVID-19感染与PSD之间存在显著相关性。然而,多元回归分析揭示了PSD与以下因素之间的关联:TSH(比值比:0.87,95%置信区间:0.76-1)、CRP水平(比值比:1.01,95%置信区间:1-1.02)、中风家族史(比值比:4.25,95%置信区间:1.66-10.88)、偏头痛病史(比值比:8.63,95%置信区间:2.49-29.85)以及较短的睡眠时间(比值比:0.6,95%置信区间:0.51-0.71)(均P<0.05)。

结论

CRP、中风家族史、偏头痛、睡眠时间和TSH被确定为COVID-19限制措施解除后PSD的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2af/11331147/b2d918ee4dec/IJGM-17-3479-g0001.jpg

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