Lu Jieyi, Zhang Lulu, Zhang Yi, Mao Huawu, Fang Qi
Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Neurology, The Fourth Affiliated Hospital of Soochow University (Dushu Lake Hospital), Suzhou, China.
Front Neurol. 2024 Nov 6;15:1385266. doi: 10.3389/fneur.2024.1385266. eCollection 2024.
Depression is common in stroke survivors and affects their recovery and quality of life (QoL). Intravenous thrombolysis (IVT) can improve post-stroke outcomes but the impact on early-onset post-stroke depression (PSD) is unclear. This was evaluated by comparing depression symptoms between patients with acute ischemic stroke (AIS) with vs. without IVT.
This retrospective cohort study included 633 patients with AIS. The 17-item Hamilton Depression Rating Scale was used to evaluate depression in patients 14-21 days after stroke onset. Propensity score matching was used to minimize intervention bias between the two groups.
Of the 633 patients, 120 (19.0%) received IVT and 513 (81%) did not. Before matching, the prevalence of early-onset PSD was lower in the IVT group than in the non-IVT group (18.3% vs. 29.2%, < 0.05). In the multivariate logistic regression analysis, the risk of early-onset PSD was significantly lower in the IVT group than in the non-IVT group [odds ratio (OR) = 0.48; 95% confidence interval: 0.28-0.83]. The results were stable after adjusting for potential confounders by inverse probability of treatment weighting and using a pairwise algorithm based on propensity scores (ORs between 0.44 and 0.61, all < 0.05); were robust to unmeasured confounding as assessed by -value analysis; and were consistent in subgroup analyses.
IVT is associated with a reduced risk of early-onset PSD and can improve the QoL of patients with AIS during post-stroke recovery.
抑郁症在中风幸存者中很常见，会影响他们的康复和生活质量（QoL）。静脉溶栓（IVT）可以改善中风后的预后，但对早期中风后抑郁症（PSD）的影响尚不清楚。通过比较接受与未接受IVT的急性缺血性中风（AIS）患者的抑郁症状来评估这一影响。
这项回顾性队列研究纳入了633例AIS患者。采用17项汉密尔顿抑郁量表评估中风发作后14至21天患者的抑郁情况。使用倾向得分匹配来最小化两组之间的干预偏倚。
在633例患者中，120例（19.0%）接受了IVT，513例（81%）未接受。匹配前，IVT组早期PSD的患病率低于非IVT组（18.3%对29.2%，<0.05）。在多因素逻辑回归分析中，IVT组早期PSD的风险显著低于非IVT组[比值比（OR）=0.48；95%置信区间：0.28 - 0.83]。通过治疗权重逆概率调整潜在混杂因素并使用基于倾向得分的配对算法后，结果稳定（OR在0.44至0.61之间，均<0.05）；通过 - 值分析评估，对未测量的混杂因素具有稳健性；并且在亚组分析中一致。
IVT与早期PSD风险降低相关，并且可以改善AIS患者中风后康复期间的生活质量。
