TY - JOUR T1 -抑郁症状与急性脑卒中风险:脑卒中间期病例对照研究JF -神经病学JO -神经病学DO - 10.1212/WNL.0000000000207093半岛投注体育官网Sp - 10.1212/ wnl.0000000000207093AU -墨菲,罗伯特•P AU - Reddin娜AU -罗森格林,安妮卡盟——法官,康纳盟,纸巾,格雷姆j . AU -弗格森,约翰•AU - Alvarez-Iglesias Alberto盟——Oveisgharan Shahram AU - Wasay,默罕默德盟-麦克德莫特,Clodagh盟——球队,赫勒克林根贝格AU -拉娜,费尔南多盟——AL-HUSSAIN FAWAZ AU - Czlonkowska安娜盟——它Aytekin盟——Ogunniyi Adesola盟——Damasceno Albertino AU -泽维尔,丹尼斯AU - Avezum,阿尔瓦罗·王盟——Xingyu盟——蓝鸿恩彼得盟——优素福Salim AU - O'Donnell, Martin AU -, Y1 - 2023/03/08 UR - http://n.n半岛投注体育官网eurology.org/content/early/2023/03/08/WNL.0000000000207093.abstract N2 -背景和目的抑郁症已被报道为急性中风的危险因素,主要基于高收入国家的研究。在INTERSTROKE研究中,我们探讨了抑郁症状对急性卒中风险和1个月预后的影响,包括世界各地区、亚人群和卒中类型。病例为CT或MRI确诊的急性住院卒中患者,对照组根据年龄、性别和部位进行匹配。标准化问题被问及过去12个月内自我报告的抑郁症状,并记录了处方抗抑郁药物的使用情况。多变量条件logistic回归用于确定卒中前抑郁症状与急性卒中风险的相关性。采用调整后的有序logistic回归探讨卒中前抑郁症状与卒中后功能结局的相关性,并在卒中后1个月用改良rankin量表进行测量。结果26877例患者中女性占40.4%,平均年龄61.7±13.4岁。在过去12个月内抑郁症状的患病率高于对照组(18.3%vs.14.1%,p < 0.001) and differed by region (pinteraction < 0.001), with lowest prevalence in China (6.9% in controls) and highest in South America (32.2% of controls). In multivariable analyses pre-stroke depressive symptoms were associated with greater odds of acute stroke (OR 1.46, 95%CI 1.34–1.58), which was significant for both intracerebral hemorrhage (OR 1.56, 95%CI 1.28–1.91) and ischemic stroke (OR 1.44, 95%CI 1.31–1.58). A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms. While pre-admission depressive symptoms were not associated with a greater odds of worse baseline stroke severity (OR 1.02, 95%CI 0.94–1.10), they were associated with a greater odds of poor functional outcome at 1-month after acute stroke (OR 1.09, 95%CI 1.01–1.19).DiscussionIn this global study we recorded that depressive symptoms are an important risk factor for acute stroke, including both ischemic and hemorrhagic stroke. Pre-admission depressive symptoms were associated with poorer functional outcome, but not baseline stroke severity, suggesting an adverse role of depressive symptoms in post-stroke recovery. ER -
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