期刊文章%A Murphy, Robert P %A Reddin, Catriona %A Rosengren, Annika %A Judge, Conor %A Hankey, Graeme J. %A Ferguson, John %A Alvarez-Iglesias, Alberto %A Oveisgharan, Shahram %A Wasay, Mohammad %A McDermott, Clodagh %A Iversen, Helle Klingenberg %A Lanas, Fernando %A AL-HUSSAIN, FAWAZ %A Czlonkowska, Anna %A Oguz, Aytekin %A Ogunniyi, Adesola %A Damasceno, Albertino %A Xavier, Denis %A Avezum, Alvaro %A Wang, Xingyu %A Langhorne, Peter %A Yusuf, Salim %A O'Donnell, Martin %A，抑郁症状与急性卒中风险:卒中间病例对照研究%D 2023 %R 10.1212/WNL。0000000000207093 [J]首页神经病学%P 10.1212/WNL。背景和目的基于高收入国家的研究，抑郁症已被报道为急性卒中的一个危险因素。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。与对照组相比，过去12个月内病例抑郁症状的患病率更高(18.3%vs.14.1%，p < 0.001)，且因地区而异(p相互作用< 0.001)，中国患病率最低(对照组为6.9%)，南美最高(对照组为32.2%)。在多变量分析中，卒中前抑郁症状与较高的急性卒中发生率相关(OR 1.46, 95%CI 1.34-1.58)，这对于脑出血(OR 1.56, 95%CI 1.28-1.91)和缺血性卒中(OR 1.44, 95%CI 1.31-1.58)均具有显著意义。 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. %U //www.ez-admanager.com/content/neurology/early/2023/03/08/WNL.0000000000207093.full.pdf

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