Abstract:Objective To investigate the influencing factors for depression and anxiety in patients with dysphagia after stroke. Methods From May 2017 to June 2018,patients with post-stroke dysphagia in the Department of Rehabilitation Medicine of Zhejiang Hospital were recruited to collect their height,weight,education level,serum nutritional indicators and feeding patterns. Self-Rating Anxiety Scale and Self-Rating Depression Scale were employed to assess the incidence of anxiety and depression. Multivariate logistic regression model was used to analyze the influencing factors for depression and anxiety. Results Among 96 patients enrolled,43 suffered from anxiety and depression,with the incidence of 44.79%. The results of multivariate logistic regression analysis showed that normal albumin(OR=0.208,95%CI:0.054-0.800)was a protective factor for anxiety,while indwelling gastric tube(OR=5.789,95%CI:1.654-20.260)was a risk factor. Normal transferrin(OR=0.189,95%CI:0.042-0.860)was a protective factor for depression,while indwelling gastric tube(OR=13.977,95%CI:1.472-132.667)was a risk factor. Conclusion Normal albumin and transferrin are the protective factors for anxiety and depression in patients with dysphagia after stroke,and indwelling gastric tube is the risk factor for anxiety or depression.
楼巍敏, 葛黎菁, 李海龙, 求佳. 脑卒中后吞咽障碍患者焦虑和抑郁情绪影响因素研究[J]. 预防医学, 2019, 31(5): 441-444.
LOU Wei-min, GE Li-jing, LI Hai-long, QIU Jia. Influencing factors for anxiety and depression in patients with dysphagia after stroke. Preventive Medicine, 2019, 31(5): 441-444.
[1] TRAVER P L .Poststroke dysphagia:implications for nurses[J]. Rehabilitation Nursing,2012,24(2):69-73. [2] MANN G,HANKEY G J,CAMERON D .Swallowing Disorders following acute stroke:prevalence and diagnostic accuracy[J]. Cerebrovascular Diseases,2000,10(5):380-386. [3] NEED H .Dysphagia following stroke[J]. International Journal of Language & Communication Disorders,2009,45(6):1-2. [4] VERDONSCHOT R J C G,BAIJENS L W J,VANBELLE S,et al. Affective symptoms in patients with oropharyngeal dysphagia:a systematic review[J]. Journal of Psychosomatic Research,2017, 97:102-110. [5] VERDONSCHOT R J C G,BAIJENS L W J,SERROYEN J L,et al. Symptoms of anxiety and depression assessed with the hospital anxiety and depression scale in patients with oropharyngeal dysphagia[J]. Journal of Psychosomatic Research,2013,75(5):451-455. [6] 脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996(6):62-64. [7] 张明园,何燕玲. 精神科评定量表手册 [M]. 长沙:湖南科学技术出版社,2015. [8] CHEN Y K,QU J F,XIAO W M,et al.Poststroke fatigue:risk factors and its effect on functional status and health-related quality of life[J]. International Journal of Stroke,2015,10(4):506-512. [9] MUTAI H,FURNKAWA T,NAKANISHI K,et al.Longitudinal functional changes,depression,and health-related quality of life among stroke survivors living at home after inpatient rehabilitation[J]. Psychogeriatrics,2016,16(3):185-190. [10] DE BRUIJN M A,SYNHAEVE N E,VAN RIJSBERGEN M W,et al. Quality of Life after Young Ischemic Stroke of Mild Severity Is Mainly Influenced by Psychological Factors[J]. J Stroke Cerebrovasc Dis,2015,24(10):2183-2188. [11] ZENG Y,YIP J,CUI H,et al.Efficacy of neuromuscular electrical stimulation in improving the negative psychological state in patients with cerebral infarction and dysphagia[J]. Neurol Res,2018,40(6):473-479. [12] HARRIS G M,COLLINS-MCNIL J,YANG Q,et al.Depression and functional status among African American stroke survivors in inpatient rehabilitation[J]. Journal of Stroke and Cerebrovascular Diseases,2017,26(1):116-124. [13] 陶学霞,邵银燕. 焦虑和抑郁对慢性阻塞性肺疾病急性加重住院患者生活质量的影响[J]. 浙江预防医学,2016,28(6):613-615. [14] CHEN N,LI Y,FANG J,et al.Risk factors for malnutrition in stroke patients:a meta-analysis[J]. Clinical Nutrition,2019,38(1):127-135. [15] KIM S,BYEON Y .Comparison of nutritional status indicators according to feeding methods in patients with acute stroke[J]. Nutritional Neuroscience,2014,17(3):138-144. [16] KIM Y,KIM M C,PARK H S,et al.Association of the anxiety/depression with nutrition intake in stroke patients[J]. Clinical Nutrition Research,2018,7(1):11-20. [17] 薛慎伍,王辉. 老年性脑卒中吞咽障碍患者营养支持研究进展[J]. 中国老年学杂志,2015,35(8):2285-2288. [18] HONG D G,YOO D H .A comparison of the swallowing function and quality of life by oral intake,level in stroke patients with dysphagia[J]. Journal of Physical Therapy Science,2017,29(9):1552-1554. [19] NAKAJIMA M,KIMURA K,INATOMI Y,et al.Intermittent oro-esophageal tube feeding in acute stroke patients- a pilot study[J]. Acta Neurologica Scandinavica,2010,113(1):36-39. [20] ALMEIDA O P,MARSH K,ALFONSO H,et al.B-vitamins reduce the long-term risk of depression after stroke:The VITATOPS-DEP trial[J]. Annals of Neurology,2010,68(4):503-510.