The Analysis Of Incidence And Related Risk Factors Of Acute Ischemic Post-stroke Depression

Objective To study the incidence rate of acute ischemic post-stroke depression and its relevant risk factors.Methods 185 cases of acute ischemic post-stroke depression of the neurology department of the Affiliated Hospital of Youjiang Medical University for Nationalities from January 2015 to January 2016 were selected. All the patients were met criteria for the diagnosis of cerebral stroke, and confirmed by head CT or MRI. The social demographic data and clinical data were collected within 2 weeks after the onset of stroke. In this study,the diagnosis of depression was made according to the Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) criteria,using the 24-item Hamilton Depression Rating Scale (HAMD) to evaluate the degree of depression,dividing into post-stroke depression (PSD) group and post-stroke no depression (non-PSD) group.We calculated the incidence rate of PSD,and compared the two groups patients of the social demographic,vascular risk factors,related biochemical indicators,stroke lesion, stroke lesion number, cerebral infarction (CI) volume,The American National Institutes of Health Stroke Scale (NIHSS) scores, Barthel index (BI) and Mini Mental Statue Examination (MMSE) scores,to understand the related factors influencing the occurrence of PSD.Results (1) A total of 185 stroke survivors were studied, 75 cases were diagnosised depression.The incidence of PSD was 40.54%, including patients with mild depression 51(27.57%), patients with moderate depression 20(10.81%)and patients with severe depression 4 (2.16%),Mild and moderate PSD were more common in this study. (2) Vascular risk factors of diabetes, obesity were related with the incidence of PSD,and more risk factors,mo re prone to PSD (P<0.05,for all); (3) The relationship between PSD and blood index: PSD was closely related with serum high-sensitivity C reactive protein and homocysterine levels.The higher level of high-sensitivity C reactive protein and homocysterine,the more serious the degree of depression (P<0.05, for all); (4) PSD patients had severe cognitive impairment and neurological deficits (P<0.05,for all); (5)Imaging classification: left frontal lobe,left temporal lobe and left basal ganglia region ischemic stroke were significantly increased in PSD group,the more bigger of the cerebral infarction volume and stroke lesion number, the more likely to cause PSD (P<0.05,for all); (6) Multiariable Logistic regression analysis indicated that low MMSE and BI scores, bigger cerebral infarction volume and multifocal cerebral stroke, high homocysteine level were independent risk factors of acute ischemic post-stroke depression.(P<0.05,for all).Conclusions (1) The incidence of PSD was 40.54%,and PSD was mainly composed of mild and moderate depression. (2) Acute ischemic post-stroke depression was closely related with history of diabetes, obesity, cognitive impairment, the extent of neurological deficit,stroke lesion, multifocal cerebral stroke, cerebral infarction volume,high-sensitivity C reactive protein and homocysterine levels. (3) low MMSE and BI scores, bigger cerebral infarction volume, more stoke lesion number, high homocysteine level might be independent risk factors of acute ischemic post-stroke depression.