情感障碍对老年人脑梗死复发率的影响

Effect of affective disorder on recurrence of cerebral infarction in the elderly

摘要:

目的 探讨情感障碍对老年脑梗死患者复发率的影响。方法 采用前瞻性对照设计，收集解放军第261医院神经内科在2012年10月1日至2013年9月30日住院期间的脑梗死首次发病患者，从中选取102例伴有情感障碍者作为观察对象，组成观察组（A组）；从同时期入院治疗的首发脑梗死患者中，入选年龄、性别、病情严重程度、合并基础病情况与观察组相匹配的无情感障碍的患者102例，组成对照组（B组），研究两组在首次发病1年内脑梗死的复发情况，并记录A组患者服用抗抑郁或（和）抗焦虑剂的依从性。结果 A组有23例患者脑梗死复发，B组为11例，A组脑梗死复发率高于B组（22.5% vs 10.8%），差异有统计学意义（P＜0.05）。A组中抑郁与焦虑共病者脑梗死复发率为36.8%，明显高于仅有抑郁（17.4%）或焦虑（21.6%）的患者。A组中服药依从性差的患者脑梗死复发率相对较高（30.4%）。结论 情感障碍是脑梗死复发的重要危险因素，服药依从性差增加复发的风险。

Abstract:

Objective To determine the effect of affective disorder on recurrence of cerebral infarction in the elderly. Methods A prospective study was carried out on 102 elderly patients with identified affective disorder who hospitalized in our Department of Neurology due to first attack of cerebral infarction from October 2012 to September 2013. They were assigned as the observation group (group A). Another 102 first-attacked cerebral infarction patients without affective disorder admitted during the same period were recruited and assigned as the pair-matched group (group B, without difference with group A in age, gender, severity of infarction, and comorbidity). These patients were followed up for 1 year. Recurrence of cerebral infarction was compared between the 2 groups. The compliance with anti-depressant or/and anti-anxiety agents was recorded in the patients of the group A. Results There were 23 patients suffering from relapsed cerebral infarction in group A, and 11 patients in group B, with the recurrence rate significantly higher in group A than in group B (22.5% vs 10.8%, P＜0.05). In group A, the recurrence rate was 36.8% in those who suffered from both coexisting depression and anxiety, significantly higher than those having depression (17.4%) or anxiety (21.6%) only. What’s more, the recurrence rate (30.4%) was comparatively higher in those with poor compliance with drug therapy. Conclusion Affective disorder is an important risk factor for recurrence of cerebral infarction in the elderly, and poor compliance with drug therapy increases the risk further.