血清FGF22水平和脑电P300对抑郁症患者发生轻度认知功能障碍的预测价值

Predictive values of serum fibroblast growth factor 22 levels and electrical P300 in occurrence of mild cognitive impairment in patients with depression

目的探讨血清成纤维细胞生长因子22(FGF22)水平和脑电P300对抑郁症患者发生轻度认知功能障碍(MCI)的预测价值。方法前瞻性收集江苏大学附属医院神经内科自2020年1月至2021年8月收治的94例抑郁症不伴认知功能障碍的患者,随访1年,期间每3个月采用汉密尔顿抑郁量表(HAMD)-24项、蒙特利尔认知评估量表(MoCA)评估患者的神经心理功能。根据是否发生MCI,将患者分为抑郁症伴MCI组(57例)、抑郁症不伴MCI组(32例)。患者均行基线P300检查并采用酶联免疫吸附实验(ELISA)检测患者血清FGF22水平。比较2组患者临床资料、P300检查结果和血清FGF22水平的差异。通过相关性分析检验患者基线P300潜伏期、血清FGF22水平与MoCA评分的相关性。采用多因素Logistics回归分析筛选抑郁症患者发生MCI的独立影响因素。采用受试者工作特征(ROC)曲线分析P300潜伏期及血清FGF22水平在预测抑郁症患者发生MCI中的应用价值。结果与抑郁症不伴MCI组比较,抑郁症伴MCI组患者的受教育年限、血清FGF22水平明显降低,独居者所占比例、P300潜伏期明显增高,差异均有统计学意义(P<0.05)。相关性分析结果显示,抑郁症伴MCI组患者发生MCI时MoCA评分与血清FGF22水平呈正相关关系(r=0.665,P<0.001),与P300潜伏期呈负相关关系(r=-0.621,P<0.001)。多因素Logistics回归分析结果显示血清FGF22水平为抑郁症患者发生MCI的保护因素(OR=0.805,95%CI:0.737~0.862,P=0.003),P300潜伏期为抑郁症患者发生MCI的危险因素(OR=1.136,95%CI:1.115~1.163,P=0.001)。ROC曲线分析显示:血清FGF22水平、P300潜伏期、血清FGF22水平联合P300潜伏期预测抑郁症患者发生MCI的ROC曲线下面积(AUC)分别为0.779、0.724、0.852。结论血清FGF22水平和P300潜伏期异常与抑郁症患者MCI发生密切相关,两者联合可用于预测抑郁症患者MCI的发生。

Objective To investigate the predictive values of serum fibroblast growth factor 22(FGF22)levels and electrical P300 in depression patients occurred mild cognitive impairment(MCI).Methods A prospective study was performed.A total of 94 depression patients without cognitive impairment admitted to our hospital from January 2020 to August 2021 were chosen.These patients were followed up for one year;Hamilton Depression Scale(HAMD)-24 items and Montreal Cognitive Assessment Scale(MoCA)were used to evaluate the neuropsychological function of the patients every 3 months;according to the occurrence of MCI,the patients were divided into depression with MCI group(n=57),and depression without MCI group(n=32).All patients underwent baseline P300 examination and baseline serum FGF22 levels were detected by enzyme-linked immunosorbent assay(ELISA),and the differences in clinical data,P300 examination results and serum FGF22 levels were compared between the two groups.Correlation analysis was performed to analyze the correlations of P300 latency and serum FGF22 level with MoCA scores.Multivariate Logistic regression analysis was used to screen the independent influence factors for MCI in patients with depression.The predictive value of P300 latency and serum FGF22 level in MCI in patients with depression was analyzed by receiver operating characteristic(ROC)curve.Results As compared with the depression without MCI group,patients in the depression with MCI group had significantly lower years of education and serum FGF22 level,and significantly higher proportion of patients living alone,and statistically higher P300 latency(P<0.05).The results of correlation analysis showed that the MoCA scores at MCI period were positively correlated with serum FGF22 level(r=0.665,P<0.001)and negatively correlated with P300 latency(r=-0.621,P<0.001)in patients from the depression with MCI group.Multivariate Logistic regression analysis showed that serum FGF22 level was a protective factor for MCI in patients with depression(OR=0.805,95%CI:0.737-0.862,P=0.003),and P300 latency was a risk factor for MCI in patients with depression(OR=1.136,95%CI:1.115-1.163,P=0.001).ROC curve analysis showed that the areas under the curve(AUC)of serum FGF22 level,P300 latency,serum FGF22 level combined with P300 latency in predicting MCI in depression patients were 0.779,0.724,and 0.852,respectively.Conclusion The abnormal serum FGF22 level and P300 latency are closely related to the occurrence of MCI in patients with depression,and the combination of the two can be used to predict the occurrence of MCI in patients with depression.