Abstract: Objective We studied the influencing factors and the qulity of life of post-stroke depressionpatiants. We also compared the therapetic effects of mental healing only or fluoxetine together tothe patients in different depression level.Methods We collected 70 patients who suffered from acute post-stroke depression, and investigatedthe patients’information, such as age, gender, marital status, career, character, education, address,Month income, Social Support, family relationship, stroke pattern, stroke times, carotid arterystenosis and accompanying diseases (including high blood pressure, diabetes, heart disease andBlood fats metabolic disorder). We divided the patients into two groups after admission. The firstgroup was given mental healing only. And the other group was given mental healing and fluoxetinetogether. We carried on grading to all patients with Hamilton Depression Rating Scales-21, SocialSupport Rating Scales, Chinese Strok Clinical Nerve Deficiency Scales and Quality of Instrumentsfor stroke patients (QOLISP 1.0).Results 1. In the patients with post-strok depression, mild despondent patients account for 57.1%,the ratio of moderate depression patients for 4.3%, and severe depression patients for 8.6%. 2. Afteranalysing by using logistic regression method, we found that the depression level was correlated with age, family relationship, stroke times and the numbers of accompanying diseases. 3. Afteranalysing by using stepwise multi-elemental regression analysis, we found that the qulity of lifeof patients with post-stroke depression was correlated with depression level, neurological deficit,career, character, stroke times and age. 4. After analysing by using the repeating survey method,wefound that the nerve function obviously restored and the quality of life obviously improved bytreatment. But the patients with mild depression showed better neurological function recovery thanthe patients with moderate or severe depression; For qulity of life, the patients with moderate orsevere depression showed the same improvement with the patients with mild depression. 5. Usingnon-parameter method to compare the therapeutic effect, we found two treatment methods showedno different effect in the patients with mild depression, but obviously different effect in the patientswith moderate or severe depression. Obviously the effect of union treatment was better than that of mental healing only.

Key words: Depression; post-stroke; Factor analysis; statiscal; Quality of life; Psychotherapy

摘要： 目的 探讨影响卒中后抑郁患者抑郁程度的相关因素，调查卒中后抑郁患者的生活质量状况，并比较单纯心理治疗与心理治疗联合氟西汀治疗对于不同抑郁程度患者的治疗效果。方法 收集急性卒中并发抑郁患者70例，调查患者的一般临床资料，包括患者的年龄、性别、婚姻、职业、性格、学历、居住地、月经济收入、社会支持、家庭关系、卒中类型、卒中次数、颈动脉狭窄、合并症（高血压、糖尿病、心脏病、脂代谢紊乱）。入院后将患者随机分为两组，一组给予单纯心理治疗（心理治疗组，n=35），另一组给予心理治疗联合氟西汀治疗（联合治疗组，n=35）。并进行Hamilton抑郁量表-21项、社会支持评定量表、中国脑卒中临床神经功能缺损程度评分量表、中风病患者生存质量量表（QOLIS 1.0版）评分。结果 ①卒中后抑郁患者中轻度抑郁所占百分比为57.1%（40/70），中度所占百分比为34.3%（24/70），重度抑郁百分比为8.6%（6/70）。②Logistic回归分析显示，年龄、家庭关系、卒中次数、合并症种数对抑郁严重程度的影响有统计学意义。③多元逐步回归分析显示，抑郁程度、神经功能缺损、职业、性格、卒中次数、年龄对卒中后抑郁患者生活质量的影响有统计学意义。④轻度抑郁患者和中重度抑郁患者经治疗后神经功能均明显恢复，生活质量均明显改善;而轻度抑郁患者的神经功能恢复较中重度抑郁患者好，生活质量改善两组之间无明显差异。⑤轻度抑郁患者两种治疗方法的治疗效果无差异，而中重度患者联合治疗优于单纯心理治疗。结论 ①加重卒中后抑郁程度的相关因素有年龄轻、家庭关系差、卒中次数多、合并症种数多。②降低卒中后抑郁患者生活质量的相关因素有抑郁程度严重、神经功能缺损程度严重、体力劳动、内向、卒中次数多、年龄大。③经治疗后轻度抑郁患者的神经功能恢复较中重度抑郁患者好，而生活质量的改善无差别。④轻度抑郁患者可以采用单纯心理治疗，中重度抑郁患者应采用联合治疗。

关键词: 抑郁症; 卒中后; 因素分析; 统计学; 生活质量; 心理疗法疗