关键词: 抑郁; 危险因素; 脑萎缩; 前瞻性队列研究

Abstract: Objective To explore the independent risk factors of post-stroke depression(PSD) at the acutestage of ischemic stroke in the stroke unit in a prospective cohort study.Methods Eligible inpatients with acute ischemic cerebrovascular diseases within 14 days afteronset were enrolled in this study. Demographic data, past history, associated clinical indicatorsand imaging data were collected. The assessments of neurological deficit and mental scale werecarried out for all the enrolled patients within 14 day after onset, and according to the depressionevaluation, all patients were divided into PSD group and non-PSD group. Demographic data andclinical data were compared between the two groups to analyze the risk factors for depression at theacute stage of ischemic stroke.Results Total of 268 patients were included in this study, 116 in PSD group and 152 in non-PSDgroup. Compared with the non-PSD group, a significantly higher proportion of patients in thePSD group were females, with a history of diabetes, and had impetuous and inward dispositions.The PSD group had significantly higher National Institutes of Health Stroke Scale(NIHSS) andlower Mini-Mental State Examination(MMSE) score than the non-PSD group on 14 days afteronset. The imaging findings showed that acute infarction at basal ganglia was associated withhigh PSD incidence; the detection rate of encephalatrophy at bilateral medial temporal lobe, rightparietal lobe, and bilateral occipital lobe were significantly higher in PSD group than that in non-PSD group. Gender(P <0.0001, OR 7.064, 95%CI 3.334-14.966) and NIHSS score on 14 daysafter onset(P =0.0020, OR 1.158, 95%CI 1.055-1.272) were the independent risk factors of PSD.Easygoing disposition before onset(P =0.0264, OR 0.447, 95%CI 0.220-0.910) was a protectivefactor for PSD.Conclusion Female-gender and neurological deficit on 14 days after onset are independent riskfactors of PSD. Easygoing disposition before onset is a protective factor for PSD.

Key words: Depression; Risk factor; Encephalatrophy; Prospective cohort study