脑卒中后抑郁患者血清瘦素、炎症因子和脑源性神经营养因子的变化及意义

Changes and Significance of Serum Leptin,Inflammatory Factors and Brain-derived Neurotrophic Factor in Patient with Post-stroke Depression

目的探讨脑卒中后抑郁患者血清瘦素、炎症因子和脑源性神经营养因子的变化及意义。方法选取2019年1月至2020年6月在乌鲁木齐市第四人民医院就诊的发病24 h以内的134例脑卒中患者作为研究对象,根据《CCMD-3中国精神障碍分类与诊断标准》和老年抑郁量表评分≥10分的标准,分别在出院后7 d和出院后1个月时筛选出有严重抑郁症状的患者,分为单纯脑卒中组和脑卒中后抑郁组。分别比较两组的血清瘦素、炎症因子(白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α、细胞间黏附分子-1和高敏C反应蛋白)和脑源性神经营养因子水平。结果134例脑卒中患者中,出院后7 d出现抑郁症状患者25例,患病率为18.7%(25/134)。出院后1个月对109例脑卒中患者进行随访,完成随访的104例患者中脑卒中后抑郁23例,患病率为22.1%(23/104)。出院后7 d和出院后1个月,脑卒中后抑郁组的血清瘦素水平明显高于单纯脑卒中组[43.4(23.4,60.2)μg/L比6.4(3.7,16.8)μg/L,46.2(34.0,117.7)μg/L比6.4(3.4,12.2)μg/L](P<0.01),两组的白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α、细胞间黏附分子-1、高敏C反应蛋白、脑源性神经营养因子水平比较差异无统计学意义(P>0.05)。结论血清瘦素水平升高与脑卒中后抑郁有相关性,可成为脑卒中后抑郁的预测因子。

Objective To explore the changes and significance of serum leptin,inflammatory factor,neurotrophic factor in patients with post-stroke depression.Methods A total of 134 stroke patients within 24 h of onset in the Fourth People′s Hospital of Urumqi City from Jan.2019 to Jun.2020 were included.According to CCMD-3 Chinese Classification and Diagnostic Criteria of Mental Disorders and the criteria of Geriatric Depression Scale score≥10,the patients with severe depressive symptoms were screened at 7 days and 1 month after discharge,respectively,and divided into a simple stroke group and a post-stroke depression group.The levels of serum leptin,inflammatory factors(interleukin-1β,interleukin-6,tumor necrosis factor-α,intercellular adhesion molecule-1 and high-sensitivity C-reactive protein)and brain-derived neurotrophic factor were compared between the two groups.Results Among the 134 stroke patients,25 cases with depression symptoms 7 days after discharge,and the prevalence rate was 18.7%(25/134).109 stroke patients were followed up one month after discharge,among the 104 patients who completed the follow-up,23 had post-stroke depression,and the prevalence rate was 22.1%(23/104).7 days after discharge and 1 month after discharge,the serum leptin level in the post-stroke depression group was significantly higher than that in the simple stroke group[43.4(23.4,60.2)μg/L vs 6.4(3.7,16.8)μg/L,46.2(34.0,117.7)μg/L vs 6.4(3.4,12.2)μg/L](P<0.01).There was no significant difference in the levels of interleukin-1β,interleukin-6,tumor necrosis factor-α,intercellular adhesion molecule-1 and high-sensitivity C-reactive protein and brain-derived neurotrophic factor(P>0.05).Conclusion The increase of serum leptin level in stroke patients is related to post-stroke depression,which can be a predictor of depression after stroke.