摘要：
目的 初步探讨抑郁障碍对颅脑创伤患者反应抑制功能的影响。方法 采用Glasgow 昏迷量表、汉密尔顿抑郁量表17 项（HAMD-17）和日常生活活动能力量表（ADL）评价104 例颅脑创伤患者（伴抑郁障碍54 例、不伴抑郁障碍50 例）颅脑创伤和抑郁障碍严重程度，刺激-反应相容性试验记录反应抑制任务反应时间。结果 颅脑创伤伴抑郁障碍组HAMD-17（P = 0.000，0.000）和ADL（P = 0.000，0.000）评分高于颅脑创伤不伴抑郁障碍组和对照组，颅脑创伤不伴抑郁障碍组HAMD-17（P = 0.000）和ADL（P = 0.000）评分亦高于对照组。无论执行相容性还是不相容性任务，颅脑创伤伴或不伴抑郁障碍组患者反应时间均长于对照组（P = 0.000，0.000），颅脑创伤伴抑郁障碍组患者反应时间亦长于颅脑创伤不伴抑郁障碍组（P = 0.000）。结论 颅脑创伤后可发生认知功能障碍，且在伤后6 个月或更长时间仍存在。颅脑创伤伴抑郁障碍可以加重患者认知功能障碍，应早期识别并及时干预。
关键词:
颅脑损伤,
抑郁,
反应抑制,
神经心理学测验
Abstract:
Objective To investigate the effect of depression on response inhibition of patients after traumatic brain injury (TBI). Methods Glasgow Coma Scale (GCS), Hamilton Depression Rating Scale-17 Items (HAMD-17) and Activities of Daily Living (ADL) were used to assess the severity of trauma, depression and activities of daily living in 104 TBI patients (54 with depression and 50 without depression). Besides, 51 normal controls with matched age, sex and education were enrolled. Stimulus-Response Compatibility (SRC) task was employed to record the reaction time (RT) of response inhibition of the subjects in 3 groups. Results Both HAMD-17 and ADL scores in TBI with depression group were significantly higher than those in TBI without depression group (P = 0.000, 0.000) and normal control group (P = 0.000, 0.000). Besides, HAMD-17 and ADL scores in TBI without depression group were significantly higher than those in normal control group (P = 0.000, 0.000). Compared with normal control group, no matter in compatible or incompatible condition, RT was significantly longer in both TBI groups (P = 0.000, 0.000). RT was much longer in TBI with depression group than that in TBI without depression group (P = 0.000). Conclusions Cognitive dysfunction is a common symptom after TBI, which may exist 6 months after injury or even longer. TBI combined with depression could aggravate the impaired cognitive function, so early identification and timely intervention is very important.
Key words:
Craniocerebral trauma,
Depression,
Reactive inhibition,
Neuropsychological tests
邵春红, 彭毅华, 诸索宇, 王志阳, 施慎逊, 孙莉敏, 白玉龙, 吴雪海. 抑郁障碍对颅脑创伤患者反应抑制功能的影响[J]. 中国现代神经疾病杂志, 2016, 16(6): 328-332.
SHAO Chun-hong, PENG Yi-hua, ZHU Suo-yu, WANG Zhi-yang, SHI Shen-xun, SUN Li-min, BAI Yu-long, WU Xue-hai. Effect of depression on response inhibition of patients after traumatic brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2016, 16(6): 328-332.