天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (3): 301-305.doi: 10.11958/20161357

• 临床研究 • 上一篇    下一篇

缺血性卒中急性期情感淡漠的发生率及相关因素分析

徐磊 1， 喻明 1， 谭华 2△   

  1. 1 四川省遂宁市中心医院神经内科 （邮编 629000）； 2 四川省西南医科大学附属医院神经内科
  • 收稿日期:2016-11-17 修回日期:2017-01-25 出版日期:2017-03-15 发布日期:2017-03-21
  • 通讯作者: 谭华 E-mail:lovei1983@aliyun.com

The incidence and related factor analysis of apathy in patients with acute ischemic stroke

XU Lei1, YU Ming1, TAN Hua2△   

  1. 1 Department of Neurology, Suining Central Hospital, Suining 629000, China; 2 Department of Neurology, the Affiliated Hospital of Southwest Medical University
  • Received:2016-11-17 Revised:2017-01-25 Published:2017-03-15 Online:2017-03-21
  • Contact: TAN Hua E-mail:lovei1983@aliyun.com

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摘要： 摘要： 目的 探讨缺血性卒中患者急性期情感淡漠的发生率及相关影响因素。方法 100 例缺血性卒中患者为病例组， 同期健康体检者 50 例为对照组。使用修订版情感淡漠评定量表（MAES）分别对其进行情感淡漠评分， 将MAES 评分＞14 分定义为情感淡漠。根据 MAES 评分将病例组分为情感淡漠组和非情感淡漠组， 比较 2 组间一般资料、 临床资料、 神经功能缺失评分量表（NIHSS）、 蒙特利尔认知量表（MoCA）、 汉密尔顿抑郁量表（HAMD）、 改良Rankin 量表 （mRS） 及病灶部位构成的差异， 将具有统计学意义的因素 （P＜0.05） 行多因素分析， 使用 Logistic 回归分析情感淡漠发生的相关影响因素。结果 病例组发生情感淡漠 34 例 （34.00%）， 对照组情感淡漠 3 例 （6.00%）， 病例组发生率高于对照组 （P＜0.001）。情感淡漠组年龄、 糖尿病发生率、 NIHSS 评分、 HAMD 评分、 脑干及多发病灶发生率高于非情感淡漠组， 而受教育年限、 MoCA 评分低于非情感淡漠组（P＜0.05）。Logistic 回归分析显示， 较高的MoCA 评分为情感淡漠的保护因素， 较高的 NIHSS 评分、 卒中发生于脑干及多病灶为情感淡漠的危险因素。结论 认知功能障碍、 神经功能缺损严重程度、 病灶在脑干及多发病灶可能是急性缺血性卒中后情感淡漠发生的相关危险因素。

关键词: 情绪障碍, Logistic 模型, 危险因素, 急性缺血性卒中, 情感淡漠

Abstract: Abstract: Objective To investigate the incidence and its related factors of apathy in patients with acute ischemic stroke. Methods A total of 100 consecutive cases of ischemic stroke patients and 50 health controls were recruited in the present study. Apathy was assessed using modified apathy evaluation scale (MAES). According to the MAES score, acute ischemic stroke patients were divided into apathy group (MAES was more than 14 points) and non- apathy group. The differences of general information, clinical data, national institutes of health stroke scale (NIHSS), Montreal cognitive assessment (MoCA), Hamilton depression scale (HAMD), modified rankin scale (mRS) and the lesion location were compared between the two groups. Differences that showed statistical significance (P < 0.05) went into the multi-factor analysis. The Logistic regression analysis was used to estimate the influence factors of apathy. Results There were 34 cases of apathy in patient group (34.00%), which was significantly higher than those of control group (3 cases of apathy, 6.00%, P＜0.001). The age, incidence of diabetes, NIHSS score, HAMD score, lesions in brain stem and multiple lesions were significantly higher in apathy group than that of non-apathy group, while educational level, MoCA score were significantly lower (P < 0.05). The Logistic regression analysis showed that the higher MoCA score was a protective factor for apathy, while higher NIHSS score,lesions in brain stem and multiple lesions were risk factors for the incidence apathy. Conclusion The cognitive impairment, severity of neurological deficits, brainstem lesions and multiple lesions may be the risk factors of apathy after the occurrence of acute ischemic stroke.

Key words: mood disorders, Logistic models, risk factors, acute ischemic stroke, apathyAcute ischemic stroke