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目的:探讨脑卒中后抑郁与患者发生A型行为及其血清内皮质醇、C-反应蛋白和同型半胱氨酸水平的关系。方法:对2011年1月～2011年12月期间在我院神经内科住院治疗的78例脑卒中患者的临床资料进行回顾性研究。我们在取得这78例患者的同意之后,对他们进行了汉密尔顿抑郁评定量表(HAMD,24项版)的检测,并将总得分超过17分的患者诊断为患有脑卒中后抑郁。结果 ,在这78例患者中,有52例患者患有脑卒中后抑郁。我们将52例患有脑卒中后抑郁的患者分为抑郁组,将另外26例没有患脑卒中后抑郁的患者分为非抑郁组,同时另选15名健康人作为对照组。我们对这三组人员发生A型行为的几率及其血清皮质醇、C-反应蛋白和同型半胱氨酸的水平进行检测。结果:抑郁组患者发生A型行为的几率及其血清皮质醇、C-反应蛋白和同型半胱氨酸的水平均明显高于非抑郁组患者和对照组人员,二者相比差异具有显著性(p<0.05)。结论:检测患者发生A型行为的几率及其血清皮质醇、C-反应蛋白和同型半胱氨酸的水平,可将其作为诊断早期脑卒中后抑郁的主要方法,值得在临床上推广使用。
Objective: To investigate the relationship between post-stroke depression and type A behavior and serum levels of cortisol, C-reactive protein and homocysteine in patients. Methods: The clinical data of 78 stroke patients admitted to Department of Neurology in our hospital from January 2011 to December 2011 were retrospectively reviewed. After obtaining the consent of the 78 patients, we tested them for the Hamilton Depression Rating Scale (HAMD, 24-band version) and diagnosed patients with a total score of more than 17 as having post-stroke depression. As a result, 52 of the 78 patients had post-stroke depression. We classified 52 patients with post-stroke depression as depression group, another 26 patients without post-stroke depression as non-depression group and 15 healthy individuals as control group. We examined the incidence of type A behavior among these three groups and their serum levels of cortisol, C-reactive protein and homocysteine. Results: The incidence of type A behavior and the levels of serum cortisol, C-reactive protein and homocysteine in depression group were significantly higher than those in non-depression group and control group, the difference was significant (p <0.05). Conclusion: Detecting the occurrence of type A behavior in patients and their serum levels of cortisol, C-reactive protein and homocysteine may be used as the primary method to diagnose post-stroke depression. It is worth to be used clinically.