血清肥胖抑制素、脑源性神经营养因子水平与缺血性脑卒中并发抑郁的关系

The Relationship Between Serum Levels of Obestatin and Brain-derived Neurotrophic Factor and Depression in Patients with Ischemia Stroke

目的探讨血清肥胖抑制素、脑源性神经营养因子(BDNF)水平与缺血性脑卒中并发抑郁的关系。方法选取2016年3月—2019年6月达州市中心医院收治的缺血性脑卒中病人132例,其中46例并发抑郁(抑郁组),86例未发生抑郁(脑卒中组),另选取54名健康志愿者为对照组。检测3组血清肥胖抑制素、BDNF水平,收集病人临床资料,采用Logistic逐步回归分析影响缺血性脑卒中病人并发抑郁的危险因素,采用受试者工作特征曲线(ROC)分析肥胖抑制素、脑源性神经营养因子诊断缺血性脑卒中病人并发抑郁的价值。结果抑郁组血清肥胖抑制素水平高于脑卒中组和对照组(P<0.05),脑卒中组血清肥胖抑制素水平高于对照组(P<0.05);抑郁组血清BDNF水平低于脑卒中组和对照组(P<0.05),脑卒中组血清BDNF水平低于对照组(P<0.05)。相关分析结果显示,缺血性脑卒中并发抑郁病人血清肥胖抑制素水平与汉密尔顿抑郁量表(HAMD)评分呈正相关(P<0.05),BDNF水平与HAMD评分呈负相关(P<0.05)。Logistic回归分析结果显示,内向型、家庭支持较少、重度神经缺损、极度严重日常生活能力障碍、血清肥胖抑制素≥3.12 ng/mL、血清BDNF<6.25μg/L是缺血性脑卒中病人发生抑郁的危险因素(P<0.05)。ROC分析结果显示,血清肥胖抑制素、BDNF、肥胖抑制素+BDNF预测缺血性脑卒中并发抑郁的曲线下面积(AUC)分别为0.699,0.667,0.921,灵敏度分别为69.57%、63.04%、89.13%,特异度分别为74.42%、68.60%、90.70%。结论缺血性脑卒中并发抑郁病人血清肥胖抑制素水平升高,BDNF水平降低,肥胖抑制素、BDNF水平与HAMD评分密切相关,是导致缺血性脑卒中并发抑郁的危险因素之一,可以为脑卒中并发抑郁评估提供参考。

Objective To investigate the relationship between serum levels of obestatin and brain-derived neurotrophic factor(BDNF)and depression in patients with ischemic stroke.Methods A total of 132 patients with ischemic stroke were selected,including 46 patients with depression(depression group)and 86 patients without depression(stroke group),and another 54 healthy volunteers were selected as control group.Serum obestatin and BDNF levels were detected,and clinical data were collected.Risk factors of depression in patients with ischemic stroke were analyzed by Logistic stepwise regression.Receiver operating characteristic curve(ROC)were used to analyze the value of serum obesostatin and BDNF levels in predicting depression in ischemic stroke patients.Results Serum obestatin level in depression group was higher than those in stroke group and control group(P<0.05),and serum obestatin level in stroke group was higher than that in control group(P<0.05).Serum BDNF level in depression group was lower than those in stroke group and control group(P<0.05),and serum BDNF level in stroke group was lower than that in control group(P<0.05).Correlation analysis results showed that serum obestatin level of patients with ischemic stroke and depression were positively correlated with Hamilton Depression Scale(HAMD)scores(P<0.05),while BDNF level was negatively correlated with HAMD scores(P<0.05).The results of Logistic stepwise regression analysis showed that introversion,less family support,severe neurological defects,extremely severe life disability,serum Obestatin≥3.12 ng/mL,and serum BDNF<6.25μg/L were risk factors for depression in patients with ischemic stroke(P<0.05).ROC analysis results showed that the area under the curve(AUC)of serum obestatin,BDNF,and obestatin+BDNF in the prediction of ischemic stroke complicated by depression was 0.699,0.667,and 0.921,respectively.The sensitivity was 69.57%,63.04%,and 89.13%,respectively,and the specificity was 74.42%,68.60%,and 90.70%,respectively.Conclusion Serum obestatin level increased and BDNF level decreased in ischemic stroke patients with depression.Serum obestatin and BDNF levels were correlated with HAMD scores,and these were the risk factors of ischemic stroke complicated by depression,which could provide reference for the assessment of stroke complicated by depression.