脑卒中后抑郁患者的炎性因子和脑源性神经营养因子水平变化及相关性分析

Changes of Levels of Inflammatory Factors and BDNF in Patients with Post-stroke Depression and Their Correlations

目的分析脑卒中后抑郁(PSD)患者炎性因子和脑源性神经营养因子(BDNF)水平变化及二者的相关性。方法选取2015年2月—2017年6月住院治疗的98例脑卒中患者,并根据是否发生PSD分为PSD组35例和无PSD组63例。采用相关量表评估两组的神经功能缺损及抑郁程度,检测血清BDNF与炎性因子水平,并进行相关性分析。结果 PSD组美国国立卫生研究院卒中量表(NIHSS)、汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)评分、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、IL-2、IL-6均显著高于无PSD组(P <0. 05)。PSD组血清BDNF水平显著低于无PSD组(P <0. 05)。轻度、中度、重度抑郁PSD患者血清BDNF水平依次降低,hs-CRP、TNF-α、IL-1、IL-2、IL-6水平依次升高,比较差异均有统计学意义(P <0. 05)。PSD患者抑郁程度与血清BDNF呈高度负相关,与血清hs-CRP、TNF-α、IL-1和IL-2呈中度正相关,与IL-6呈高度正相关(P <0. 05)。且PSD患者血清BDNF水平与NIHSS、HAMD和SDS评分呈中度负相关,与血清hs-CRP、TNF-α、IL-1和IL-2呈高度负相关(P <0. 05)。结论炎性因子及BDNF在PSD发病机制中占重要地位,且二者具有显著相关性。

Objective To analyze changes of levels of inflammatory factors and brain-derived neurotrophic factor(BDNF)in patients with post-stroke depression(PSD)and their correlations.Methods A total of 98 stroke patients admitted during February 2015 and June 2017 were divided into PSD group(n=35)and non-PSD group(n=63)according to whether or not having PSD.In two groups,degrees of neurologic impairment and depression were assessed by related scales,and levels of serum BDNF and inflammatory factors were detected,and the correlation was analyzed.Results National Institutes of Health Stroke Scale(NIHSS),Hamilton depression scale(HAMD)and self-rating depression scale(SDS)scores,levels of high-sensitivity C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),IL-2 and IL-6 in PSD group were significantly higher than those in non-PSD group(P<0.05).Serum BDNF level in PSD group was significantly lower than that in non-PSD group(P<0.05).Serum BDNF levels were decreased in turn,while hs-CRP,TNF-α,IL-1,IL-2 and IL-6 levels were increased in turn in patients with mild,moderate and severe PSD,and the differences were statistically significant(P<0.05).Degree of depression was highly negatively correlated with serum BDNF level,moderately positively correlated with serum hs-CRP,TNF-α,IL-1 and IL-2 levels,and highly positively correlated with IL-6 level in patients with PSD(P<0.05).Serum BDNF level was moderately negatively correlated with NIHSS,HAMD and SDS scores,and highly negatively correlated with serum hs-CRP,TNF-α,IL-1 and IL-2 in patients with PSD(P<0.05).Conclusion Inflammatory factors and BDNF play important role in pathogenesis of PSD,and there is a significant correlation in each other.