脑卒中后抑郁患者检测SEP与血浆5-羟色胺的临床意义

Clinical significance of SEP and plasma 5-HT in post stroke depression

目的探讨脑卒中后抑郁(post-stroke depression,PSD)患者体感诱发电位(somatosensory evoked potential,SEP)与血浆5-羟色胺(5-hydroxytryptamine,5-HT)水平的变化及其相关性,为脑卒中后抑郁的诊断及预后提供科学依据。方法单纯脑卒中组(n=19)、脑卒中后抑郁组(n=17),采用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)判断抑郁程度,另设正常对照组(n=12),检测3组体感诱发电位N9、N13、N20的潜伏期及波幅;检测各组血浆5-HT含量,比较分析3组体感诱发电位和血浆5-HT含量。结果脑卒中患者、脑卒中后抑郁患者正中神经测定N20的潜伏期及波幅异常率较正常人高(P<0.05);脑卒中后抑郁组血浆中5-HT含量明显低于正常对照组或脑卒中组,差异显著均有统计学意义(P<0.05);脑卒中后抑郁患者HAMD评分与N20潜伏期呈正相关、与N20波幅呈负相关,N9波幅、N9潜伏期、N13波幅、N13潜伏期、N20波幅无相关;脑卒中后抑郁组HAMD评分与血浆中5-HT含量呈负相关。结论脑卒中后抑郁患者血浆中5-HT含量明显低于正常人或脑卒中患者,并且脑卒中后抑郁患者及脑卒中患者正中神经测定N20波幅及潜伏期异常率明显高于正常组。因此,检测脑卒中患者的SEP中N20波幅、潜伏期及血浆5-HT水平,将对脑卒中后抑郁的诊断及预后具有很好的临床意义。

Objective To investigate the correlation between somatosensory evoked potential （ SEP） of post-stroke depression （PSD） patients and plasma 5-HT levels,so as to provide scientific basis for the diagnosis and prognosis of PSD . Methods In stroke group （n=19） and PSD group （n=17）,Hamilton Depression Scale （HAMD） was used to measure the depression degree,and a normal group （n=12） was set for control,while the latent period and amplitude of SEP N9, N13 and N20 were detected;the plasma 5-HT contents of the three groups were detected , and the SEP and plasma 5-HT contents of the three groups were compared and analyzed .Results Stroke patients and PSD patients had higher abnormal rates of N20 latent period and amplitude of median nerve than normal people （P〈0.05）;the plasma 5-HT content of PSD group was obviously lower than that of the control group and the stroke group ,and the differences were of statistical signifi-cance （P〈0.05）;the PSD patients’HAMD scores were positively correlated with N20 latent period and negatively related to N20 amplitude,unrelated with N9 amplitude,N9 latent period,N13 amplitude,N13 latent period and N20 amplitude;in the PSD group,HAMD scores were negatively related to plasma 5-HT.Conclusion The plasma 5-HT content of PSD pa-tients was significantly lower than that of normal people or stroke patients ,and the PSD group and stroke group had remark-ably higher abnormal rates of N 20 amplitude and latent period of median nerves than the normal group .Consequently ,it is of great clinical significance to detect N 20 amplitude,latent period and plasma 5-HT levels of stroke patients for the diagnosis of PSD and prognosis .