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目的探讨抑郁障碍对基底节区脑梗死早期运动障碍加重的影响。方法收集首次发病的基底节区急性脑梗死患者85例,所有患者完善头颅磁共振成像(MRI)+磁共振血管成像(MRA)+弥散加权成像(DWI)检查。入院时通过Hamilton抑郁量表评分,将入选患者分为无抑郁障碍组和抑郁障碍组;入院后依据美国国立卫生脑卒中量表(NIHSS)对早期运动障碍动态评分,将以上每组再分成稳定亚组和进展亚组。比较各组的早期运动障碍进展发生率、梗死灶体积前后比(V2/V1)、大脑中动脉(MCA)病变及血压、血脂、空腹血糖。结果 1.抑郁障碍组早期运动障碍进展率(10/27,37.04%)明显高于无抑郁障碍组(9/58,15.52%)(χ2=4.92,P=0.03);2.基底节区脑梗死存在明显MCA狭窄或闭塞(37/85,43.53%),抑郁障碍组与无抑郁障碍组MCA病变差异无统计学意义(χ2=0.34,P=0.56);3.进展亚组V2/V1大于稳定亚组;在进展亚组中,抑郁障碍组V2/V1与无抑郁障碍组差异有统计学意义(F=167.39,P=0.00);4.收缩压、空腹血糖在病情进展时明显偏高,其中空腹血糖与抑郁障碍存在明显相关性(r=0.425,P=0.000)。结论抑郁障碍能促进基底节区脑梗死早期运动障碍进展。
Objective To investigate the effect of depression on the aggravation of early dyskinesia in basal ganglia patients with cerebral infarction. Methods Totally 85 patients with acute onset of basal ganglia infarction were collected, and all patients were examined by MR magnetic resonance imaging (MRA) and diffusion weighted imaging (DWI). On admission, the Hamilton Depression Scale score was used to divide the patients into two groups: depression-free group and depression group. According to the National Health Stroke Scale (NIHSS), the dynamic scores of early dyskinesia after admission were divided into stable groups Subgroups and Progress Subgroups. The incidence of early dyskinesia, infarct volume anteversion ratio (V2 / V1), middle cerebral artery (MCA), blood pressure, blood lipids and fasting blood glucose were compared between groups. Results 1. The rate of early dyskinesia (10/27, 37.04%) in depression group was significantly higher than that in non-depressive disorder group (9/58, 15.52%) (χ2 = 4.92, P = 0.03) There was no significant difference of MCA between depression group and non-depression group (χ2 = 0.34, P = 0.56); (3) The subgroup V2 / V1 was more than Stable subgroup; in the progress subgroup, there was significant difference between depression group V2 / V1 and non-depression group (F = 167.39, P = 0.00); 4. Systolic blood pressure and fasting blood glucose were significantly higher when the disease progressed , Of which there was a significant correlation between fasting blood glucose and depression (r = 0.425, P = 0.000). Conclusion Depression can promote the early dyskinesia in basal ganglia infarction.