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目的:探讨急性期脑卒中患者影像学改变在脑卒中后抑郁(PSD)患者中的相关性和临床意义,期望早期发现PSD患者并为及时干预提供帮助。方法:对329例急性脑卒中后1个月内患者采用系统的神经心理评估和MRI检查。所有患者均常规行汉密尔顿抑郁量表(HAMD)评分,根据头颅MRI结果分析病变部位。结果:PSD的发病率以左侧半球脑卒中患者明显高于双侧和右侧半球脑卒中患者,且左侧额叶和基底节尤为突出。不同病灶数目组间比较,PSD的发生率以多灶患者明显高于单灶患者(P<0.01)。结论:急性脑卒中后PSD与病变部位在左侧半球尤其是左侧额叶、颞叶和基底节区具有显著相关性。完全前循环梗死也是易患PSD的危险因素。
OBJECTIVE: To investigate the correlation and clinical significance of the imaging changes in acute stroke patients with post-stroke depression (PSD). We expect to find early PSD patients and provide assistance for timely intervention. METHODS: A systematic neuropsychological assessment and MRI were performed in 329 patients with acute stroke within one month. The Hamilton Depression Rating Scale (HAMD) was routinely used in all patients, and the lesions were analyzed according to the cranial MRI results. Results: The incidence of PSD in patients with left hemisphere stroke was significantly higher than those in bilateral and right hemisphere stroke patients, and the left frontal lobe and basal ganglia were particularly prominent. The incidence of PSD in multifocal patients was significantly higher than that in single patients (P <0.01). CONCLUSIONS: There is a significant correlation between PSD and lesions in the left hemisphere, especially in the left frontal lobe, temporal lobe and basal ganglia after acute stroke. Complete anterior circulation infarction is also a risk factor for PSD.