摘要：

目的 探讨脑卒中后情感失禁（PESI）的发生率及其相关危险因素。方法 记录162 例脑卒中患者性别、年龄、体重指数、受教育程度、婚姻状况、既往史（高血压、心脏病、糖尿病、高脂血症，吸烟史、饮酒史）、脑卒中家族史，检测血清同型半胱氨酸水平，行头部CT 和（或）MRI 检查明确脑卒中类型、病灶部位和病灶数目；采用美国精神障碍诊断与统计手册第5 版中文版和汉密尔顿抑郁量表17 项评价抑郁程度，House 诊断标准诊断脑卒中后情感失禁。单因素和多因素后退法Logistic 回归分析筛查脑卒中后情感失禁的相关危险因素，Spearman 秩相关分析探讨脑卒中后情感失禁与脑卒中后抑郁的相关性。结果 162 例患者中12 例诊断为脑卒中后情感失禁，发生率为7.41%。脑卒中后情感失禁组年龄<60 岁比例高于（P = 0.045）、吸烟比例低于（P = 0.036）非PESI组。单因素和多因素后退法Logistic 回归分析显示，年龄< 60 岁是脑卒中后情感失禁的独立危险因素（OR = 4.000，95%CI：1.149 ~ 13.924；P =0.029）。12 例脑卒中后情感失禁患者中10 例并发脑卒中后抑郁，共病率为83.33%；Spearman 秩相关分 析显示，脑卒中后情感失禁与脑卒中后抑郁呈正相关（r_s = 0.305，P = 0.000）。结论 脑卒中后情感失禁是脑卒中患者的常见情感障碍，易发生于年龄< 60 岁的患者。

关键词: 卒中, 情感障碍, 抑郁, 危险因素, 回归分析

Abstract:

Objective  To investigate the occurrence rate and related risk factors for post-stroke emotional incontinence (PSEI).  Methods  The clinical data [sex, age, body mass index (BMI), education, marital status, medical history (hypertension, heart disease, diabetes, hyperlipemia, smoking and drinking) and family history of stroke] of 162 stroke patients were recorded. Serum homocysteine (Hcy) level was examined. Head CT and/or MRI were used to indicate stroke subtype, site of lesion and number of lesion. Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-Ⅴ) Chinese version and Hamilton Depression Rating Scale-17 Items (HAMD-17) were used to evaluate the degree of depression. House diagnostic standard was used to diagnose PSEI. Univariate and multivariate backward Logistic regression analysis was used to screen related risk factor for PSEI. Spearman rank correlation analysis was used to discuss the correlation between PSEI and post-stroke depression (PSD).  Results  Among 162 stroke patients, 12 cases were diagnosed as PSEI (7.41% ). The ratio of age < 60 years in PSEI group was significantly higher than non-PSEI group (P = 0.045). The ratio of smoking in PSEI group was significantly lower than non-PSEI group (P = 0.036). Univariate and multivariate backward Logistic regression analysis showed age < 60 years was independent risk factor for PSEI (OR = 4.000, 95%CI: 1.149-13.924; P = 0.029). Ten cases were combined with PSD in 12 PSEI patients, and the co-morbidity rate of PSEI and PSD was83.33%. Spearman rank correlation analysis showed PSEI was positively related to PSD (r_s = 0.305, P = 0.000).  Conclusions  PSEI is common affective disorder in stroke patients, which easily happens in patients under 60 years of age.

Key words: Stroke, Affective disorders, Depression, Risk factors, Regression analysis