卒中后抑郁患者血浆非酶类抗氧化物水平的研究

Plasma levels of non enzymatic antioxidants in patients with post-stroke depression

目的探讨卒中后抑郁(post-stroke depression,PSD)患者的血浆非酶类抗氧化物水平及临床意义。方法研究共纳入急性缺血性脑卒中患者230例;根据汉密尔顿抑郁量表(HAMD-24)评分将患者分为抑郁组(PSD组)和非抑郁组(NPSD组);PSD组分为轻度组、中度组和重度组;测定各组患者的血浆白蛋白(ALB)、胆红素(TBIL)和尿酸(UA)水平。结果纳入的230例患者中,PSD组患者106例,NPSD组患者124例,两组患者的ALB、TBIL、UA比较,差异均具有统计学意义(均P<0.05);PSD轻度组患者51例,中度组29例,重度组26例,各组患者的ALB、TBIL、UA比较,差异均具有统计学意义(均P<0.05);Logistic回归分析显示,年龄大、有精神疾病家族史、非首发卒中均是PSD的危险因素,ALB和UA是PSD的保护因素。结论氧化应激反应参与了PSD的发生,PSD患者存在非酶类抗氧化物水平的失调。

Objective To investigate the level and clinical significance of plasma non enzymatic antioxidants in patients with post-stroke depression(PSD). Methods A total of 230 patients with acute ischemic stroke were included in the study. The patients were divided into depression group(PSD group)and non-depression group(NPSD group)according to the Hamilton Depression Scale(HAMD-24)score. The PSD group was divided into mild group,moderate group and severe group according to the score. Plasma albumin(ALB),bilirubin(TBIL)and uric acid(UA)levels were determined in each group. Results Among the 230 patients included,106 in PSD group and 124 in NPSD group. There were significant differences in ALB,TBIL and UA between the two groups(all P< 0.05);51 in PSD mild group,29 in moderate group and 26 in moderate group. There were significant differences in ALB,TBIL and UA between the two groups(all P<0.05). Nonconditional logistic regression analysis showed that age,family history of mental illness and non-first stroke were all risk factors for PSD,and albumin and uric acid were protective factors for PSD. Conclusion Oxidative stress is involved in the occurrence of post-stroke depression. There is a disorder of non enzymatic antioxidant level in patients with post-stroke depression.