青年人群卒中后抑郁与阿替普酶静脉溶栓相关性的临床研究

Clinical research on the association between intravenous thrombolysis with alteplase and post-stroke depression in young people

摘要:

目的 探讨阿替普酶静脉溶栓是否可以降低青年缺血性脑卒中患者卒中后抑郁(PSD)的发生率以及青年卒中患者PSD的影响因素。方法 回顾性分析210例青年缺血性脑卒中患者临床资料，根据是否使用阿替普酶静脉溶栓分为溶栓组（110例）和非溶栓组（100例）。比较2组患者在发病14 d及发病3个月时PSD的发生率。采用单因素分析及Logistic回归分析青年卒中患者PSD的影响因素。结果 发病14 d时溶栓组和非溶栓组青年卒中患者PSD发生率差异有统计学意义(χ²=3.988，P<0.05)；发病3个月时2组PSD发生率差异无统计学意义(χ²=1.432，P>0.05)。Logistic回归分析显示NIHSS评分、是否静脉溶栓为发病14 d时发生PSD的影响因素；NIHSS评分、社会支持为发病3个月时发生PSD的影响因素。结论 青年卒中患者PSD发生率较高；阿替普酶静脉溶栓可以降低青年卒中患者PSD的发生率。

Abstract:

Objective To investigate whether intravenous thrombolysis with alteplase can reduce the incidence of post-stroke depression （PSD） in young patients with ischemic stroke， and to analyze the influencing factors for PSD in young stroke patients.Methods A retrospective analysis was performed on the clinical data of 210 young ischemic stroke patients. The patients were divided into thrombolysis group （n=110） and non-thrombolysis group （n=100） according to whether to use alteplase for intravenous thrombolysis. The two groups were compared in terms of PSD incidence at 14 days and 3 months after onset. The univariate analysis and logistic regression were used to analyze the influencing factors for PSD in young stroke patients.Results At 14 days after onset， there was a significant difference in PSD incidence between the two groups （χ²=3.988， P<0.05）， while at 3 months after onset， there was no significant difference （χ²=1.432， P>0.05）. The logistic regression analysis indicated that National Institutes of Health Stroke Scale （NIHSS） score and whether to use intravenous thrombolysis were the influencing factors for PSD at 14 days after onset， while NIHSS score and social support were the influencing factors for PSD at 3 months after onset.Conclusions The incidence of PSD is relatively high in young stroke patients， and intravenous thrombolysis with alteplase can reduce it.