老年卒中后抑郁患者血浆瘦素及胰岛素样生长因子-1水平的相关性研究

Study on the serum leptin and IGF-1 in the elderly patients with post-stroke depression

目的 探讨老年卒中后抑郁患者血清瘦素（leptin）、胰岛素样生长因子-1（IGF-1）、脑源性神经营养因子（BDNF）及炎性标志物水平变化及意义.方法 以老年缺血性卒中患者为研究对象,采用汉密尔顿抑郁量表筛选符合条件的卒中后抑郁患者46例,选择不伴抑郁的老年卒中患者50例为对照组.于住院第3周,应用酶联免疫吸附法检测患者血清leptin、IGF-1、BDNF以及炎性标志物超敏C反应蛋白（hsCRP）、细胞间黏附分子（ICAM-1）浓度.结果 （1）卒中后抑郁组血清leptin和IGF-1浓度[分别为（57.4±14.32）ng/ml、（120.86±28.66）ng/ml]较对照组[分别为（17.53±11.62）ng/ml、（66.5±17.51）ng/ml]明显增高,差异有显著性意义（P＜0.01）.（2）卒中后抑郁组血清hs-CRP[（2.3±0.42）mg/dl]、ICMA-1[（182.6±50.27）ng/ml]、BDNF[（25.8±8.35）ng/ml]与对照组hs-CRP[（2.2±0.28）mg/dl]、ICMA-1[（178.7±51.14 ng/ml]、BDNF[（24.2±7.48）ng/ml]比较差异无显著性（P＞0.05）.（3）血浆leptin和IGF-1与HAMD显著相关（相关系数分别为：r=0.724,P＜0.01;r=0.641,P＜0.01）.结论 Leptin和IGF-1与老年卒中后抑郁关系密切,可能是老年卒中后抑郁的血清标志物.

Objective To investigate the effects of serum levels of leptin, IGF-1, BDNF and inflammatory markers in patients with post-stroke depression（PSD）. Methods By using Hamilton rating scale for depression （HAMD） ,46 patients with post-stroke depression were recruited and 50 patients without depression as the control group. Two weeks after the onset of stroke, serum levels of leptin, insulin growth factor（IGF-1）, hs-CRP, intracellular adhesion molecule （ICAM-1） and brain-derived neurotrophic factors （BDNF） were measured by enzymelinked immunosorbent assay（ELISA）. Results The levels of leptin and IGF-1 in patients with PSD were significantly higher than that of the control group （（ 57.4 ± 14.32） ng/ml vs （17.53 ± 11.62） ng/ml, P = 0. 002;（120.86 ±28.66） ng/ml vs （66.5 ± 17.51） ng/ml, P=0. 004 respectively）. The serum levels of leptin and IGFI were positively correlated with the HAMD score（r=0. 724, P〈0. 01; r=0. 641, P〈0. 01 respectively）. There was no significant differences in the levels of hs-CRP（（2.3 ±0.42） mg/dl vs （2.2 ± 0.28） mg/dl, P= 0. 767）,ICAM-1 （（ 182.6 ± 50.27） ng/ml vs （178.7 ± 51.14） ng/ml, P = 0. 812） and BDNF（（ 25.8 ± 8.35） ng/ml vs （24.2 ±7.48）ng/ml, P = 0.580）in the two groups. Conclusion The serum levels of leptin and IGF-1 may be associated with post-stroke depression and may be the markers of PSD in the old stroke patients.