摘要
目的 观察卒中后抑郁(PSD)的发生与中缝核(BR)回声的关系,探讨BR回声异常对PSD的诊断价值.方法 选取2023年1月至8月洛阳市中心医院神经内科收治的240例脑卒中患者作为研究对象,依据汉密尔顿抑郁量表评分分为PSD组及无抑郁(NPSD)组,分别进行经颅超声(TCS)检查,比较两组间的一般资料和超声资料.结果 两组的性别、年龄、疾病病程、高血压病史、冠心病史、糖尿病史、吸烟饮酒史、黑质(SN)阳性率与第三脑室(V3)增宽率比较,差异无统计学意义(P＞0.05).两组的文化程度、脑卒中次数、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力Barthel指数(BI)评分、BR阳性率比较,差异有统计学意义(P＜0.05).多因素logistic 回归分析显示,BI 指数(OR=1.847,95％CI:1.01～2.79,P＜0.001)和 BR 阳性(OR=4.432,95％CI:1.15～8.96,P＜0.001)是PSD的独立危险因素.ROC曲线分析显示,两者联合诊断PSD的AUC为0.881(95％CI:0.83～0.94).结论 BR阳性可以作为PSD的辅助诊断指标,联合BI指数可提高诊断效能.
Abstract
Objective To explore the relationship between the occurrence of post-stroke depression(PSD)and the echogenicity of the brainstem raphe(BR),and exploring the diagnostic value of abnormal echogenicity of the BR for PSD.Methods A total of 240 stroke patients admitted to the Department of Neurology,Luoyang Central Hospital from January to August 2023 were selected as study objects,they were divided into PSD group and non-post stroke depression(NPSD)group according to Hamilton depression scale score.Transcranial ultrasound(TCS)examination was performed respectively,and the general and ultrasonic data between the two groups were compared.Results There was no significant difference in gender,age,disease course,hypertension history,coronary heart disease history,diabetes history,smoking and drinking history,the positive rate of substantia nigra(SN)and the widening rate of the third ventricle(V3)between the two groups(P＞0.05).There were significant differences in education level,stroke frequency,National Institutes of Health stroke scale(NIHSS)score,activity of daily living Barthel index(BI)score and BR positive rate between the two groups(P＜0.05).Multivariate logistic regression analysis showed that BI index(OR=1.847,95％CI:1.01-2.79,P＜0.001)and BR positive(OR=4.432,95％CI:1.15-8.96,P＜0.001)were independent risk factors for PSD.ROC curve analysis showed that the AUC of the combined diagnosis of PSD was 0.881(95％CI:0.83-0.94).Conclusion BR positive can be used as an auxiliary diagnostic index for PSD,and BI index combined can improve the diagnostic efficiency.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210869)
河南省洛阳市医疗卫生指导性科技计划(2302042Y)
维普
万方数据