| Objectives 1 Retrospective study on the incidence of post-stroke depression(PSD)in patients with cerebral infarction;2 Compare the differences of general data,vascular high risk factors,blood biochemical indexes,scale scores and other related factors between patients with PSD and non-PSD patients with cerebral infarction;3 Use binary logistic regression analysis to further understand the risk factors of PSD with cerebral infarction;4 Explore the clinical efficacy of repetitive transcranial magnetic stimulation(r TMS)at different frequencies in the treatment of cerebral infarction PSD.Methods 1 Use the method of retrospective clinical study,185 patients with cerebral infarction who met the inclusion criteria in the three departments of Neurology of Hebei Provincial people's Hospital from January 2017 to December 2019 were graded with HAMD-24.According to the diagnostic criteria of PSD recommended by Chinese experts in Clinical practice of Post Stroke Depression,the patients were divided into PSD group and non-PSD group,and the incidence of PSD was calculated.The general conditions,vascular risk factors,blood biochemical indexes,scale scores were compared between the two groups to explore the related risk factors of cerebral infarction PSD.2 A total of 45 PSD patients with cerebral infarction were included.They were randomly divided into low frequency treatment group,high frequency treatment group and control group,with 15 patients in each group,The low frequency group was treated with r TMS in the right dorsolateral prefrontal cortex(R-DLPFC)at the frequency of 1Hz,the sequence interval was 0s,and the total number of pulses was 1200,once a day for 10 consecutive days.The high frequency treatment group was treated with r TMS in the left dorsolateral prefrontal cortex,L-DLPFC)at the frequency of 10 Hz,with 50 pulses per sequence at an interval of 1 minute,20 pulses at a time,with a total number of 1000 pulses once a day for 10 consecutive days,while the control group was given routine support therapy for 10 consecutive days,All patients in the three groups were treated with the HAMD-24,the Mini-Mental State Examination(MMSE),and The Pittsburgh Sleep Quality Index(PSQI)was used to assess the depression,cognitive function,and sleep of patients.Results 1 The incidence of PSD was 35.14%.2 There was only difference in the general data between the two groups(P<0.05).3 There was no difference in the vascular high risk factors between the two groups(P>0.05).4 Compared with the non-PSD group,the PSD group had higher NIHSS score,lower MMSE score and lower ADL score,and there was difference between the two groups(P<0.05).Binary Logistic regression analysis showed that NIHSS score was an independent risk factor for PSD.5 Before r TMS treatment,there was no difference in HAMD-24 score,MMSE score and PSQI score among the three groups(P>0.05).After 10 days of treatment,the HAMD score of the high frequency treatment group was lower than that of the low frequency treatment group and the control group(P<0.05),but there was no difference between the control group and the low frequency treatment group(P>0.05).There was no difference in MMSE scores among low frequency treatment group,high frequency treatment group and control group before and after treatment(P>0.05).After 10 days of treatment,the PSQI score in the low frequency treatment group and high frequency treatment group was significantly lower than that in the control group(P<0.05),and the PSQI score in the low frequency treatment group was significantly lower than that in the high frequency treatment group(P<0.05).Conclusions 1 The incidence of PSD with cerebral infarction is high.2 Female patient?Severe neurological impairment?Cognitive decline?A decline in the ability of daily living are more likely to develop cerebral infarction PSD.3 NIHSS score may be an independent risk factor for PSD with cerebral infarction.4 High frequency r TMS therapy can improve the depressive symptoms of patients;5 Short-term r TMS treatment did not significantly improve the cognitive function of patients;6 r TMS treatment can improve the sleep status of patients,and compared with high-frequency r TMS treatment group,low-frequency r TMS treatment improved sleep status more significantly.Figure 0;Table 9;Reference 262... |
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