摘要
目的调查未破裂颅内动脉瘤患者的认知和焦虑、抑郁状态,为临床干预提供依据。方法采用方便抽样的方法,回顾性连续纳入2017年9月至2018年2月首都医科大学宣武医院神经外科收治的106例未破裂颅内动脉瘤住院患者作为研究对象。使用蒙特利尔认知评估量表(MoCA),对其认知状态进行评估,并将所有患者分为认知正常组(26例)与认知障碍组(80例)。使用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评估所有患者焦虑、抑郁水平。应用SPSS 24. 0软件进行两组间各指标差异的统计学分析。结果 (1) MoCA评分:106例患者MoCA评分7～30[26(22,28)]分,26例(24. 5%)患者总体认知水平出现异常,认知正常组与认知障碍组患者Mo CA评分差异有统计学意义[27(25,29)分比20(15,22)分,Z=-6. 438,P <0. 01]。(2) HAMA评分:总体HAMA评分10. 0(5. 8,16. 0)分,其中可能焦虑33例(31. 1%),肯定焦虑28例(26. 4%),明显焦虑10例(9. 4%),严重焦虑1例(0. 9%);认知正常组与认知障碍组患者HAMA评分[8. 5(5. 0,15. 0)分比12. 5(6. 0,22. 0)分]差异无统计学意义(P> 0. 05),两组焦虑程度差异有统计学意义(P <0. 05)。(3) HAMD评分:总体HAMD评分7. 0(3. 0,11. 0)分,其中轻度抑郁46例(43. 4%),中度抑郁5例(4. 7%),重度抑郁2例(1. 9%),认知正常组与认知障碍组患者HAMD评分[6. 0(3. 0,9. 8)分比8. 5(4. 5,16. 2)分]及抑郁程度差异均有统计学意义(均P <0. 05)。(4) MoCA评分与HAMA、HAMD评分相关性:MoCA评分与HAMA、HAMD评分均呈负相关(相关系数r值分别为-0. 231、-0. 318,P值分别为0. 017、0. 001)。结论未破裂颅内动脉瘤患者的认知水平与焦虑、抑郁情绪关系紧密相关。焦虑、抑郁情绪普遍存在于未破裂颅内动脉瘤患者中,有必要对其进行针对性的心理干预。
Objective To investigate cognitive,anxious and depressive states in patients with unruptured intracranial aneurysm in order to provide a basis for clinical intervention. Methods From September 2017 to February 2018,a total of 106 consecutive patients with unruptured intracranial aneurysm admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University using convenience sampling method were enrolled retrospectively. Montreal Cognitive Assessment Scale(MoCA) was used to evaluate their cognitive status,and all patients were divided into either a cognitive normal group(n = 26) or a cognitive impaired group(n = 80). Hamilton Anxiety Scale(HAMA) and the Hamilton Depression Scale(HAMD) were used to evaluate the anxious and depressive levels of all patients. SPSS 24. 0 software was used to conduct statistical analysis of the differences of each indicator between the two groups. Results(1) MoCA score: The MoCA scores of 106 patients ranged from 7 to 30(26 [22,28]). The overall cognitive level of26 cases(24. 5%) was abnormal. There was a significant difference in Mo CA score between the cognitive normal group and the cognitive impairment group(27 [25,29] vs. 20 [15,22 ],Z =-6. 438,P <0. 01).(2) HAMA score: The overall HAMA score was 10. 0(5. 8,16. 0),of which 33(31. 1%) were possibly anxiety,28(26. 4%) were affirmative anxiety,10(9. 4%) were obvious anxiety,and 1(0. 9%)was serious anxiety. There was no significant difference in the HAMA scores of the patients between the cognitive normal group and the cognitive impaired group(8. 5 [5. 0,15. 0] vs. 12. 5 [6. 0,22. 0 ],P >0. 05). There was significant difference in the degree of anxiety between the two groups(P < 0. 05).(3) HAMD score: The overall HAMD score was 7. 0(3. 0,11. 0),including 46 cases(43. 4%) of mild depression,5 cases(4. 7%) of moderate depression,and 2 cases(1. 9%) of severe depression. There were significant differences in HAMD score(6. 0 [3. 0,9. 8]vs. 8. 5 [4. 5,16. 2]) and the degree of depression between the cognitive normal group and
作者
王军
焦菡怡
关欣
纪媛媛
张娜芹
王娜
Wang Jun;Jiao Hanyi;Guan Xin;Ji Yuanyuan;Zhang Naqin;Wang Na(Department of Neurosurgery ,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2018年第12期634-638,共5页
Chinese Journal of Cerebrovascular Diseases
基金
国家重点研发计划项目(2016YFC1300800)
关键词
颅内动脉瘤
未破裂
认知
焦虑
抑郁
Intracranial aneurysm,unruptured
Cognition
Anxiety
Depression
