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目的 :探析认知损害与抑郁在皮质下缺血性血管病(SIVD)中的相互作用。方法 :分析2014年2月~2015年12月在我院接受治疗的106例SIVD患者的临床资料。其中轻度认知损害者48例(A组),痴呆者36例(B组),无认知损害者22例(C组)。根据SIVD者的临床特征及老年抑郁量表-30项(GDS-30)评分情况,将SIVD患者分成抑郁组(>10分,72例)和无抑郁组(≤10分,34例)两组。比较A、B、C三组患者的认知功能及抑郁组与无抑郁组患者的认知损害情况。多因素分析SIVD患者抑郁与认知功能损害的相关关系。结果 :A、B、C三组患者的MMSE评分和CAMCOG-C评分组间比较具有显著性差异,且均为A组最高,C组最低。抑郁组与无抑郁组患者的Framingham评分与MMSE评分无显著差异性,但抑郁组患者的GDS评分显著低于无抑郁组,CAMCOG-C评分显著高于无抑郁组。认知功能损害程度主效应在CAMCOG-C全部子项中均差异显著;抑郁程度主效应在CAMCOG-C大部分子项中也差异显著;但两者的相互作用只在语言总分、语言理解、注意及执行中差异显著。结论 :SIVD患者有着不同程度抑郁症状及认知损害症状,且SIVD并发抑郁的患者认知受损现象更为严重,认知损害与抑郁症状相互影响。
Objective: To explore the interaction between cognitive impairment and depression in subcortical ischemic vascular disease (SIVD). Methods: Clinical data of 106 SIVD patients treated in our hospital from February 2014 to December 2015 were analyzed. There were 48 cases with mild cognitive impairment (group A), 36 cases with dementia (group B) and 22 cases without cognitive impairment (group C). SIVD patients were divided into depression group (> 10 points, 72 cases) and depression-free group (≤10 points, 34 cases) according to the clinical characteristics of the patients with SIVD and the score of GDS-30. . The cognitive function of A, B and C patients and the cognitive impairment of depression group and depression group were compared. Multivariate analysis of the correlation between depression and cognitive impairment in SIVD patients. Results: The scores of MMSE and CAMCOG-C in group A, B and C were significantly different between groups, and were the highest in group A and the lowest in group C. There was no significant difference between Framingham score and MMSE score in depression group and non-depression group, but GDS score in depression group was significantly lower than that in non-depression group, and CAMCOG-C score was significantly higher than non-depression group. The main effects of cognitive impairment were significant in all sub-items of CAMCOG-C. The main effect of depression was also significant in most sub-items of CAMCOG-C. However, the interaction between the two was only significant in language score, language comprehension , Attention and implementation of significant differences. Conclusion: Patients with SIVD have depressive symptoms and cognitive impairment symptoms in different degrees. Patients with SIVD complicated with depression suffer from more severe cognitive impairment and cognitive impairment with depressive symptoms.