Jonkman E J, de Weerd A W, Vrijens N L
Department of Clinical Neurophysiology of the Academic Hospital "Vrije Universiteit", Amsterdam, The Netherlands.
Acta Neurol Scand. 1998 Sep;98(3):169-75. doi: 10.1111/j.1600-0404.1998.tb07289.x.
Studies on determinants of quality of life (QOL) after a stroke focus on one aspect (most important: neurological deficit, mood disorders or cognitive failure) and as such provide no insight in the relative contribution of each factor on QOL. The groups of patients studied often contain victims of different types of stroke. This inhomogenity in patients leads to further confusion about QOL after stroke.
To evaluate in one study factors important for QOL in the period 3-12 months after a first one-sided ischemic stroke in the region of the middle cerebral artery.
Measures for QOL (Sickness Impact Profile, SIP), cognitive status (Wechsler Adult Intelligence Scale revised), mood and neurological deficit were scored 3. 6 and 12 months after the stroke.
Successive patients admitted to a general hospital and rehabilitation clinic in The Hague, The Netherlands.
A complete examination was performed three times in 35 patients. The results were compared to those of 20 controls matched for age, last occupation and educational level.
There was no significant neurological improvement between 3 and 12 months after the stroke. Cognition was impaired when compared to the estimated premorbid level and to the controls. There was incomplete recovery over the study interval. The patients as a group were depressed and remained so over the period of the study. The resulting quality of life scores were abnormal at 3 months and improved only slightly. Stepwise regression analysis revealed that depression and degree of paresis were the most important variables for the SIPtotal outcome.
In a homogenous group of stroke patients the QOL improved somewhat in the period 3 to 12 months after the stroke but was still highly abnormal after 1 year. The decrease in QOL was correlated with depression and - to some degree - with neurological deficit, but not to cognitive disturbances.
关于中风后生活质量（QOL）决定因素的研究聚焦于某一个方面（最重要的是：神经功能缺损、情绪障碍或认知功能障碍），因此无法洞察每个因素对生活质量的相对贡献。所研究的患者群体通常包含不同类型中风的受害者。患者的这种异质性导致对中风后生活质量的进一步困惑。
在一项研究中评估大脑中动脉区域首次单侧缺血性中风后3至12个月内对生活质量重要的因素。
在中风后3、6和12个月对生活质量（疾病影响量表，SIP）、认知状态（韦氏成人智力量表修订版）、情绪和神经功能缺损进行评分。
荷兰海牙一家综合医院和康复诊所收治的连续患者。
对35名患者进行了三次全面检查。将结果与20名年龄、既往职业和教育水平相匹配的对照组进行比较。
中风后3至12个月神经功能无显著改善。与预计的病前水平和对照组相比，认知功能受损。在研究期间恢复不完全。作为一个群体，患者在研究期间一直处于抑郁状态。由此产生的生活质量评分在3个月时异常，仅略有改善。逐步回归分析显示，抑郁和麻痹程度是SIP总结果的最重要变量。
在一组同质的中风患者中，中风后3至12个月生活质量有所改善，但1年后仍高度异常。生活质量的下降与抑郁以及在一定程度上与神经功能缺损相关，但与认知障碍无关。
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