中文摘要：

目的初步探讨缺血性脑卒中急性期抑郁发生与脑白质疏松的关系。方法对东南大学附属中大医院神经内科自2007年6月至2011年3月收治的168例缺血性脑卒中急性期患者入院后均行头颅磁共振检查。在脑卒中发病14d参照美国精神障碍诊断与统计手册第4版（DSM-1V）诊断标准进行脑卒中后抑郁的诊断，其中60例（35．7％）患者发生脑卒中后抑郁（脑卒中后抑郁组），剩余患者中随机选取年龄与性别相匹配的60例脑卒中后非抑郁患者纳入脑卒中后非抑郁组。对2组患者采用Fazekas评分方法和年龄相关的白质改变（ARWMC）量表评估脑白质疏松的部位及严重程度，并且依据各变量在单因素分析中的检验水平（P〈0．05）及临床意义筛选进入多因素Logistic回归分析中以探讨脑卒中后抑郁的危险因素。结果脑卒中后抑郁组深部脑白质高信号（DWMHs）评分和额叶区ARWMC评分明显高于脑卒中后非抑郁组，差异有统计学意3L（P〈0．05）。2组间脑室旁白质高信号（PVWMHs）及顶枕区、颞区、幕下区、基底节区ARWMC评分比较差异均无统计学意义（P〉0．05）。多因素Logistic回归分析显示，DWMHs是缺血性脑卒中急性期抑郁发生的独立危险因素（OR：1．740，95％CI：1．194—2．536，P=0．004）。结论严重的深部脑白质疏松可能增加缺血性脑卒中急性期抑郁发生的易患性。

英文摘要：

Objective To evaluate the relationship between post-stroke depression （PSD） and leukoaraiosis in a well-defined acute ischemic stroke cohort. Methods One hundred and sixty-eight patients with acute ischemic stroke, admitted to our hospital from June 2007 to March 2011, were examined by magnetic resonance imaging. The patients were made a diagnosis of post-stroke depression by the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition （DSM-IV） criteria 2 weeks after the index stroke; 60 （35.7%） patients had PSD in the acute period and 60 stroke patients without depression matched according to age and gender served as a control group were chosen. The distribution and severity of leukoaraiosis were evaluated using scale developed by Fazekas and age-related white matter changes （ARWMC） scale. The risk factors of PSD were chosen after univariate analysis and multivariate logistic regression analysis. Results In comparison with the non-PSD group, patients in the PSD group were more likely to have high deep white matter hyperintensities （DWMHs） scores and ARWMC scale scores in the frontal area with significant difference （P〈0.05）. There were no significant differences in periventricular white matter hypertensities （PVWMHs） scores and ARWMC scale scores in the parieto-occipital area, temporal area, infratentorial area and basal ganglia area between the PSD and control groups （P〉0.05）. In the multivariate logistic regression analysis, DWMHs remained an independent risk factor of PSD （OR： 1.740, 95%CI： 1.194-2.536, P=0.004）. Conclusion There may be an association between PSD and leukoaraiosis; severe leukoaraiosis in the deep area may increasevulnerability to develop depression in the acute period after ischemic stroke.