血浆同型半胱氨酸及MTHFR基因多态性与卒中后抑郁的相关性

Association of plasma homocysteine and MTHFR gene polymorphisms with post stroke depression

卒中后抑郁(PSD)是脑卒中后常见的躯体及精神症状的一种情感障碍性疾病,是脑卒中常见的并发症之一。患者往往在卒中后1个月至2年内有焦虑、抑郁甚至自杀的念头,严重影响患者的身心健康。目前其发病机制主要有两种学说:反应性机制学说和原发性内源机制学说。近年来研究表明,血浆同型半胱氨酸(Hcy)水平升高及5,10-亚甲基四氢叶酸还原酶(MTHFR)中C-T突变与PSD的发生有关,主要是通过高Hcy水平对神经元产生神经毒性作用及影响神经递质的合成进而导致PSD的发生。对PSD患者可以给予抗抑郁药物治疗及经颅磁刺激等新兴的治疗措施。但目前尚缺少一个大样本、多中心、随机对照研究进一步明确血浆Hcy水平及MTHFR基因多态性与PSD症状的相关性。

Post stroke depression（ PSD） is one of the most common somatic and psychiatric symptoms after stroke,and it is one of the common complications of stroke. Patients tend to have anxiety,depression and suicidal thoughts in the 1 months to 2 years after the stroke,which seriously affect the physical and mental health of the patients. At present,there are two kinds of the pathogenesis theories： reaction mechanism theory and the primary endogenous mechanism theory. Entered the study show that,the high homocysteine（ Hcy） hyperlipidemia and MTHFR gene C-T mutation and PSD are related to the occurrence,mainly through increasing level of Hcy on neurons produce neurotoxicity in rats and the effect of neurotransmitter synthesis and lead to the PSD. PSD patients can be given antidepressant drug treatment and transcranial magnetic stimulation and other emerging treatment measures. But there is lack of correlation between a large sample,multicenter,randomized study to further clarify the levels of Hcy and MTHFR gene polymorphism and PSD symptoms.