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目的:分析脑卒中后抑郁(PSD)与梗死部位及甲状腺功能的相关性分析,为早期干预治疗提供依据。方法:选择2011年1月-2013年12月我院收治的142例急性缺血性脑卒中患者,根据汉密尔顿抑郁量表(HAMD)评分<8分判定为PSD,分析PSD与梗死部位、游离三碘甲状腺氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)等甲状腺功能指标的关系。结果:PSD的发生率为38.7%,左侧半球、皮质、前部的PSD发生率较高;入院第7d,非PSD组和PSD组FT3明显下降(t=6.45,14.33;P<0.05)、FT4明显升高(t=8.13,16.52;P<0.05),但PSD组TSH显著低于非PSD组(t=9.83,P<0.05),与对照组比较无显著性差异(P>0.05);入院第14d,非PSD组各甲状腺功能指标基本恢复正常,但PSD组FT3、FT4与对照组比较有显著性差异(t=8.40,9.15;P<0.05);入院第2d、7d、14d,随着抑郁症状的加重,PSD患者血清FT3水平依次降低(F=29.59,22.37,12.13;P<0.05)。结论:PSD与梗死部位及甲状腺功能异常密切相关,以左侧半球、皮质、前部的PSD发生率较高,且对HPT轴的抑制时间较长。寻找PSD的干预靶点并早期防治,有助于促进脑卒中的康复。
OBJECTIVE: To analyze the correlation between post-stroke depression (PSD) and infarction location and thyroid function, and provide the basis for early intervention. Methods: A total of 142 acute ischemic stroke patients admitted to our hospital from January 2011 to December 2013 were selected as the PSD according to the Hamilton Depression Rating Scale (HAMD) score <8 and the PSD and infarct size were analyzed. Thyroid acid (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and other thyroid function indicators. Results: The incidence of PSD was 38.7%, and the left hemisphere, cortex and anterior PSD were higher. On the 7th day after admission, FT3 in non-PSD group and PSD group decreased significantly (t = 6.45,14.33; P <0.05) (T = 8.13,16.52; P <0.05). However, TSH in PSD group was significantly lower than that in non - PSD group (t = 9.83, P <0.05) On the 14th day after admission, all thyroid function indexes returned to normal in the non-PSD group, but there were significant differences between the two groups (t = 8.40,9.15; P <0.05) on the 3rd, 4th, With the aggravation of depressive symptoms, serum FT3 level in PSD patients decreased in turn (F = 29.59,22.37,12.13; P <0.05). Conclusion: PSD is closely related to the infarction site and abnormal thyroid function. The incidence of PSD in the left hemisphere, cortex and anterior segment is high, and the inhibitory time to HPT axis is longer. Looking for PSD intervention targets and early prevention and treatment, contribute to the promotion of stroke rehabilitation.