Abstract:

Objective To explore potential categories of post-stroke depression in acute-phase stroke patients and its correlation with the degree of neurological deficits，and to provide references for healthcare professionals in developing targeted interventions. Methods Using convenience sampling，patients with acute stroke who were hospitalized in neurological ward of 2 tertiary general hospitals in Henan Province from January to April 2024 were selected as the survey participants. The investigation was conducted using the General Information Questionnaire，the National Institute of Health Stroke Scale，and the Patient Health Questionnaire-9. The correlation between potential categories of post-stroke depression and the degree of neurological deficit was analysed using unordered multiclassified logistic regression. Results Post-stroke depression score was 10.22±3.61 in 193 acute-phase stroke patients，and post-stroke depression could be categorized into 3 potential categories，namely“low depressive symptoms”（44.6%），“melancholic depression”（15.0%），and “atypical depression”（40.4%）. There was a significant difference in the degree of neurological deficits（H=38.074，P<0.001）.Compared with severe neurological deficits，patients with mild deficits were more likely to be categorized as “melancholic depression”（OR=0.016，P=0.001） and “atypical depression”（OR=0.040，P<0.001），and patients with moderate deficits were more likely to be classified as “atypical depression”（OR=0.085，P=0.001）. Conclusion Post-stroke depression in acute-phase stroke patients has obvious categorization characteristics，and it is recommended that healthcare professionals should pay more attention to patients with different degrees of neurological deficits and adopt targeted interventions according to the different categories of post-stroke depression in order to alleviate their depressive symptoms.

Key words: Acute Phase, Stroke, Post-Stroke Depression, Latent Category Analysis, Degree of Neurological Deficit, Nursing Care

摘要：

目的 探讨急性期脑卒中患者卒中后抑郁的潜在类别及其与神经功能缺损程度的相关性，为临床医护人员制订针对性的干预措施提供参考。 方法 采用便利抽样法，选取2024年1月—4月在河南省2所三级甲等综合医院神经内科住院的193例急性期脑卒中患者作为调查对象，使用一般资料调查表、美国国立卫生院卒中量表和患者健康问卷进行调查。采用无序多分类Logistic回归分析卒中后抑郁潜在类别与神经功能缺损程度的相关性。 结果 193例急性期脑卒中患者卒中后抑郁得分为（10.22±3.61）分，卒中后抑郁可分为低抑郁症状组（44.6%）、忧郁型抑郁组（15.0%）、非典型抑郁组（40.4%）3个潜在类别，不同潜在类别脑卒中患者的神经功能缺损程度差异具有统计学意义（P<0.001），与重度神经功能缺损相比，轻度缺损患者更可能归于“忧郁型抑郁组”（OR=0.016，P=0.001）和“非典型抑郁组”（OR=0.040，P<0.001），中度缺损患者更可能归于“非典型抑郁组”（OR=0.085，P=0.001）。 结论 急性期脑卒中患者卒中后抑郁存在明显的分类特征，建议医护人员应加大对不同神经功能缺损程度患者的关注，根据卒中后抑郁的不同类别采取针对性的干预措施以减轻其抑郁症状。

关键词: 急性期, 脑卒中, 卒中后抑郁, 潜在类别分析, 神经功能缺损程度, 护理