目的 探讨脑卒中后抑郁(PSD)与颈动脉粥样硬化的关系.方法 304例缺血性脑梗死患者,根据汉密尔顿抑郁量表(HAMD)评分结果,总分<8分者为非PSD组,≥8分者为PSD组,比较两组颈动脉内-中膜厚度(CIMT)和颈动脉粥样硬化斑块情况,分析PSD发生的危险因素.结果 PSD组CIMT增厚检出率(97.0%)较非PSD组(74.4%)高(P<0.01),PSD组CIMT厚度〔(1.78±0.68)mm〕大于非PSD组〔(1.27±0.36)mm〕(P<0.01);PSD组斑块检出率(89.1%)较非PSD组(73.9%)高(P<0.01),PSD组斑块面积〔(26.22±0.28)mm.2〕大于非PSD组〔(13.25±0.16)mm.2〕(P<0.01).两组患者年龄、脑卒中次数和病灶数量比较差异有统计学意义(P<0.05).Logistic回归分析结果显示,CIMT(P=0.000,OR=7.143,95%CI:3.559~14.335)和颈动脉粥样硬化斑块(P=0.020,OR=5.033,95%CI:1.288~19.665)是PSD的危险因素.结论 CIMT和颈动脉粥样硬化斑块是PSD发生的危险因素.%Objective To investigate the relationship between post-stroke depression (PSD) and carotid artery atherosclerosis.Methods A total of 304 cerebral ischemic stroke patients hospitalized in department of neurology in North China University of Science and Technology from November 2015 to May 2016 were selected.According to the score of Hamilton depression (HAMD), those who got the aggregate score <8 points were divided into the non-PSD group, while the others were divided into the PSD group.The carotid intima-media thickness (CIMT) and carotid atherosclerotic plaques were compared, and the risk factors for PSD were analyzed.Results The detection rate of thickening of CIMT in the PSD group (97.0%)was higher than that of the non-PSD group (74.4%,P<0.01);the CIMT thickness of the PSD group〔(1.78±0.68)mm〕 was greater than that of the non-PSD group 〔(1.27±0.36)mm,P< 0.01〕;the detection rate of plaque in the PSD group (89.1%) was higher than that of the non-PSD group (73.9%,P<0.01);the plaque area of PSD group〔(26.22±0.28)mm.2〕 was greater than that of the non-PSD group 〔(13.25±0.16)mm.2,P<0.01)〕.The CIMT(P=0.000,OR=7.143,95%CI:3.559~14.335)and carotid atherosclerosis plaque (P=0.020,OR=5.033,95%CI:1.288~19.665) were risk factors for the PSD according to Logistic regression analysis.Conclusions The CIMT and carotid atherosclerotic plaques are important risk factors of PSD.The clinical screening can refer to those indexes.
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