Abstract: Objective To investigate the incidence of post-stroke depression (PSD) and its related risk factors.Methods The incidence of PSD was evaluated with 17 items Hamilton depressive scale (HAMD)at 2 weeks, 3 and 6 months after acute stroke of 101 inpatients. The Modified Rankin Scales (mRS),mini-mental state examination (MMSE) and the National Institutes of Health Stroke Scale (NIHSS)were also assessed. We investigated the incidence of PSD and analyzed the impact of post-strokedepression clinical factors associated risk.Results (1) The incidence of first episode PSD was significantly higher in 2 weeks (45.5%)than 3 months (6.4%) or 6 months (7.3%)(P <0. 01). There was no significant difference abouttotal incidence of PSD between 2 weeks, 3 and 6 months. The remission incidence of PSD wassignificantly higher in 3 months (23.9%) than 3 to 6 months (3.1%)(P =0.029) period. The mortalityof PSD patients was significantly higher than that of the non-PSD patients (P <0.05). (2) Theincidence of PSD was significantly higher in the patients with the left hemisphere lesion than thepatients with bilateral or right hemisphere in 2 weeks (P <0.05). The MMSE score of the PSDpatients was significantly lower than that of the non-PSD patients at both 2 weeks, 3 and 6 months(P <0.01). The mRS and NIHSS score of PSD patients were significantly higher than those ofthe non-PSD patients at all the three time points (P <0.01). (3) The related factors of post-strokedepression at 2 weeks included the lesion location in the left hemisphere of lesion, NIHSS and mRS.The related factors of post-stroke depression at 3 months and 6 months included NIHSS and mRS(P <0.05). The incidence of PSD was not related with MMSE at 2 weeks ,3 or 6 months (P >0.05).(4) We found no statistically significant difference in sex, age, stroke type, stroke localization, focusnumbers, hypertension, diabetes, culture degree (P >0.05).Conclusion PSD might have high incidence in 2 weeks after stroke. The degree of NIHSS andmRS, the left hemisphere lesion in 2 weeks showed a significant relationship with the PSD.

Key words: Stroke; Depressive disorder; Incidence; Risk factors; Epidemiology

摘要： 目的 前瞻性随访研究住院患者卒中后抑郁（post-stroke depression，PSD）发病率及其相关危险因素。方法 采用17项汉密尔顿抑郁量表（Hamilton Depression Scale, HAMD）对101例卒中住院患者在2周、3个月和6个月时分别进行抑郁情绪评定，调查住院患者中卒中后抑郁的发病率，同时测评患者一般资料、改良Rankin量表（modified Rankin Scales，mRS）、美国国立卫生研究院卒中量表（the NationalInstitutes of Health Stroke Scale，NIHSS）以及简明智力测验（mini-mental state examination，MMSE），分析影响卒中后抑郁的相关临床因素。结果 （1）PSD 2周时首次发生率显著高于3个月和6个月（45.5% vs 6.4%，P <0.01；45.5% vs7.3%，P <0.01），PSD总体发生率在2周、3个月和6个月时无统计学差异（P >0.05），PSD患者3个月内抑郁缓解率显著高于3～6个月期间（23.9% vs 3.1%，P =0.029），PSD患者死亡率显著高于非PSD患者（P <0.05）；（2）2周时左侧半球卒中患者PSD发生率显著高于右侧和双侧卒中患者（P =0.047），2周、3个月和6个月时PSD患者MMSE评分显著低于非PSD患者（P均<0.01），而mRS和NIHSS评分显著高于非PSD患者（均P <0.01）；（3）2周时PSD的发生与NIHSS（P <0.01）、mRS（P <0.01）、左侧半球卒中相关；而3个月和6个月时PSD的发生与NIHSS和mRS相关（P均<0.05）；2周、3个月和6个月时PSD的发生与MMSE无关（P >0.05）。（4）未发现PSD与性别、年龄、卒中性质、病灶数目、高血压、糖尿病、文化程度相关（P >0.05）。结论 PSD可能多发于卒中后2周内，NIHSS、mRS评分及2周大脑半球病变与PSD发生显著相关。

关键词: 卒中; 抑郁症; 发病率; 危险因素; 流行病学