老年脑卒中患者血清皮质醇水平与卒中后抑郁的相关性研究

Relativity study between serum cortisol level and post-stroke depression in old patients with stroke

目的探讨老年脑卒中患者血清皮质醇水平与卒中后抑郁（PSD）是否具有相关性。方法对41例老年卒中患者在发病后2周进行血清皮质醇检测，并在发病后3月对患者进行抑郁量表评定，观察皮质醇正常组以及皮质醇增高组卒中后抑郁发生率，并进行卡方检验，同时对各组内皮质醇水平和抑郁程度进行相关性分析。结果皮质醇正常组和皮质醇增高组PSD发生率差异有显著性（Х^2=4．11；P〈0．05），皮质醇正常组平均汉密尔顿分值为（15．29±7．28）分，皮质醇增高组为（25．85±10．81）分，2组差异有显著性（P〈0．01）。皮质醇正常组皮质醇水平与抑郁程度无明显相关（r=0．295；P=0．194），皮质醇增高组皮质醇水平与抑郁程度明显相关（r=0．702；P=0．001）。结论老年人脑卒中后早期皮质醇水平增高提示患者发生抑郁可能性增大，检测皮质醇可以为PSD防治提供理论依据据。

Objective To explore relativity between serum eortisol and post-stroke depression in old patients with stroke. Methods Serum eortisols of 41 stroke patients were examined two weeks after stroke, and they were all assessed through Hamilton Depression Scale and then happening rates of post-stroke depression observed in both normal cortisol group and enhanced cortisol group were tested through X2 test. Meanwhile relativity between serum cortisol level and post-stroke depression were analysised. Results Happening rates of post-stroke depression had an evidently difference between both normal cortisol group and enhanced cortisol group （Х^2 = 4.11 ; P 〈 0.05）. Mark of normal eortisol group was 15.29 ± 7.28, enhanced cortisol group was 25.85 ± 10.81, both groups had an evidently difference（P〈0.01 ）. Serum cortisols were not obviously relative to depression degree in normal cortisol group（r= 0. 295; P = 0. 194） while they were obviously relative in enhanced cortisel group （r = 0. 702; P = 0. 001 ）. Conclusion Enhanced cortisol could forecast higher possibility of depression after the old post-stroke, and detecting cortisol could offer theory foundation for prevention and cure of post-stroke depression.