急性脑梗死患者脑微出血病症分布及出血后抑郁临床研究

Effect of fluoxetine in elderly patients with chronic heart failure and depression

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2019, 46(3)
作者
作者单位

郑州市第一人民医院 ;

摘要
探讨急性脑梗死患者脑微出血病症分布及出血后抑郁临床研究。方法:选取2015年8月-2017年8月在本院诊治的102例急性脑梗死患者,经影像学检查将患者分为脑微出血组和无脑微出血组。比较两组的一般资料、HAMD评分、血液生化指标及影像学检查结果,记录脑微出血病灶的数目及分布部位,并采用单因素、多因素Logistic回归分析急性脑梗死患者脑微出血的临床发生率及相关危险因素。结果:通过头部核磁共振扫描检查,有59例急性脑梗死患者脑内存在脑微出血病灶,43例急性脑梗死患者脑内未发现脑微出血病灶,临床发生率为57.84%。共扫描出脑微出血病灶514个,平均8.71个。主要分布在:病灶位于基底节/丘脑区有24例患者,共203个病灶(39.49%),数目最多;病灶位于脑叶-皮层下有20例患者,有183个病灶(28.60%);病灶位于幕下区有15例患者,共128个病灶(24.90%)。脑微出血组HAMD评分为(18.15±4.37)分,高于无脑微出血组(6.29±3.42)分,比较差异有统计学意义(P<0.05)。经过单因素Logistic回归分析年龄、高血压、脑卒中、脑白质疏松、脑隙行梗死与急性脑梗死患者脑微出血存在相关性,血液生化指标与急性脑梗死患者脑微出血不存在相关性。经过多因素Logistic回归分析,年龄、高血压、脑白质疏松、脑隙性梗死是急性脑梗死患者发生脑微出血的独立危险因素。结论:急性脑梗死患者脑微出血的临床发生率较高,病灶主要分布在基底节/丘脑区,年龄、高血压、脑白质疏松、脑隙性梗死是急性脑梗死患者发生脑微出血的独立危险因素,临床诊疗中要对于出现抑郁的脑微出血患者应及时进行干预。
Abstract
To investigate the clinical incidence, distribution and related risk factors of cerebral microbleeds in patients with acute cerebral infarction.Methods: A total of 102 patients with acute cerebral infarction who were treated in our hospital from August 2015 to August 2017 were enrolled. The patients were divided into cerebral microbleeds and non-brain microbleeds by imaging examination.Compare the general data,HAMD score, blood biochemical indicators and imaging findings of the two groups, and record the number and distribution of brain microbleeds.Single factor and multivariate logistic regression were used to analyze the clinical incidence and related risk factors of cerebral microbleeds in patients with acute cerebral infarction.ResultsS: Through the head MRI scan, 59 patients with acute cerebral infarction had cerebral microbleeds in the brain, and 43 patients with acute cerebral infarction did not find cerebral microbleeds in the brain. The clinical incidence rate was 57.84%. A total of 514 brain microbleeds were scanned, with an average of 8.71. Mainly distributed in: the lesions located in the basal ganglia / thalamus area of ​​24 patients, a total of 203 lesions (39.49%), the largest number; lesions located in the brain lobe - cortex 20 patients, 183 lesions (28.60%); lesions There were 15 patients in the lower part of the area, with a total of 128 lesions (24.90%). The HAMD score of the cerebral microbleeds group was (18.15±4.37), which was higher than that of the non-brain microbleeding group (6.29±3.42), and the difference was statistically significant (P<0.05). One-way logistic regression analysis showed that there was a correlation between age, hypertension, stroke, leukoaraiosis, cerebral infarction and cerebral microhemorrhage in patients with acute cerebral infarction. There was no correlation between blood biochemical parameters and cerebral microbleeds in patients with acute cerebral infarction. After multivariate logistic regression analysis, age, hypertension, leukoaraiosis, and cerebral infarction were independent risk factors for cerebral microbleeds in patients with acute cerebral infarction.Conclusion: The clinical incidence of cerebral microbleeds in patients with acute cerebral infarction is high. The lesions are mainly distributed in the basal ganglia/thalamic area. Age, hypertension, leukoaraiosis and cerebral infarction are independent risk factors for cerebral microbleeds in patients with acute cerebral infarction. The incidence of depression in patients with cerebral microbleeds was higher than that in patients without cerebral microbleeds.
关键词
急性脑梗死;脑微出血;精神评分;抑郁状况;危险因素
KeyWord
acute cerebral infarction; cerebral microbleeds; mental score; depression status; risk factors
基金项目
页码 521-523
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王朝刚*,王昆,徐晓玉,邰剑青,张晓曼. 急性脑梗死患者脑微出血病症分布及出血后抑郁临床研究 [J]. 国际精神病学杂志. 2019; 46; (3). 521 - 523.

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