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目的 探讨颅脑损伤术后脑出血与抑郁症发生的关系.方法 选取2015年3月至2017年3月本院颅脑损伤患者70例为研究对象,均行手术治疗,按术后是否发生脑出血分为观察组(n=30)、对照组(n=40),对比两组术后美国国立卫生研究院卒中量表评分(NIHSS)、汉密尔顿抑郁量表评分(HAMD)、哥斯拉哥昏迷评分(GCS)及血清白介素-1(IL-1)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平,对比不同程度脑出血患者上述指标,分析颅脑损伤患者术后HAMD评分与其他指标相关性,并分析导致颅脑损伤术后抑郁症发生的影响因素及独立危险因素 观察组术后抑郁发生率高于对照组(X2 =5.619,P＜0.05);观察组术后NIHSS、HAMD评分及血清IL-1、IL-6、hs-CRP水平高于对照组(t=13.655、36.587、45.274、46.334、70.489,P均＜0.05),而GCS评分低于对照组(t=15.517,P＜0.05).与轻度、中度脑出血者比较,重度脑出血患者NIHSS、HAMD评分及血清IL-1、IL-6、hs-CRP较高(F=8.825、10.254、23.615、18.745、7.245,P均＜0.05),而GCS评分较低(F=7.459,P＜0.05);相关分析显示颅脑损伤患者术后HAMD评分与NIHSS评分、血清IL-1、IL-6、hs-CRP呈正相关(r=0.289、0.364、0.333、0.258,P均＜0.05),与GCS评分呈负相关(r=-0.276,P＜0.05).单因素分析显示文化程度、性格、脑出血程度及血清IL-6、hs-CRP是影响颅脑损伤患者术后抑郁的因素(t/x2=6.076、6.300、8.361,30.224、99.575,P均＜0.05),多因素分析显示脑出血程度、hs-CRP是其术后抑郁的独立危险因素(P＜0.05).结论颅脑损伤术后脑出血与抑郁症发生关系密切,可能与患者颅脑创伤后脑出血导致应激性炎症因子增多有关.“,”Objective To explore the relationship between cerebral hemorrhage and the occurrence of depression after craniocerebral injury surgery.Methods From March 2015 to March 2017,70 patients with craniocerebral injury in our hospital were selected as the subjects of study.They were divided into the observation group (n =30) and the control group (n =40) according to whether there was cerebral hemorrhage after operation.The National Institutes of Health Stroke Scale score (NIHSS),Hamilton Depression Scale score (HAMD),Glasgow Coma Score (GCS) and the levels of interleukin (IL)-1,IL-6 and high sensitivity C-reactive protein (hs-CRP) in patients with different degrees of cerebral hemorrhage were compared.The correlation between HAMD score and other indexes was analyzed.The influencing factors and independent risk factors of depression were analyzed.Results The levels of NIHSS,HAMD score and serum IL-1,IL-6 and hs-CRP in the observation group were higher than those in the control group after operation (t =13.655,36.587,45.274,46.334,70.489,P ＜ 0.05),while the GCS score was lower than that in the control group (t =15.517,P ＜ 0.05).Compared with mild and moderate cerebral hemorrhage,the NIHSS,HAMD scores and serum IL-1,IL-6 and hs-CRP were higher in patients with severe cerebral hemorrhage (F =8.825,10.254,23.615,18.745,7.245,P ＜ 0.05),while the GCS score was lower (F =7.459,P ＜ 0.05).The correlation analysis showed that the postoperative HAMD score was positively correlated with NIHSS score and serum IL-1,IL-6 and hs-CRP (r =0.289,0.364,0.333,0.258,P ＜ 0.05)and negatively correlated with the GCS score (r =-0.276,P ＜ 0.05).Univariate analysis showed that the level of culture,personality,cerebral hemorrhage degree and serum IL-6 and hs-CRP were the influencing factors of postoperative depression in patients with craniocerebral injury (t orx2 =6.076,6.300,8.361,30.224,99.575,P ＜ 0.05).Multivariate analysis showed that cerebral hemorrhage and hs-CRP were an independent risk factor for postoperative depression (P ＜ 0.05).Conclusions Cerebral hemorrhage after craniocerebral injury is closely related to the occurrence of depression,which may be related to the increase of stress-induced inflammatory factors after cerebral hemorrhage.