血清Hcy、皮质醇联合脑电P300对抑郁症患者发生轻度认知功能障碍的预测价值

Value of serum Hcy,Cor,and EEG P300 in predicting the mild cognitive impairment in depressed patients

目的 探究血清同型半胱氨酸(Hcy)、皮质醇联合脑电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156例抑郁症患者,随访1年,期间每3个月采用汉密尔顿抑郁量表(HAMD)-17项、蒙特利尔认知评估量表(MoCA)评估患者的神经心理功能。根据患者是否发生MCI将患者分为MCI组和非MCI组。患者均行脑电P300检查,并检测血清Hcy水平、血清皮质醇水平。采用logistic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)曲线评估血清Hcy水平、血清皮质醇水平及脑电P300在预测抑郁症患者发生MCI中的应用价值。结果 低血清Hcy水平、血清皮质醇水平、脑电P300均是抑郁症患者发生MCI的保护因素(OR分别=0.71、0.87、0.87,P均<0.05)。ROC曲线分析结果显示:血清Hcy水平、血清皮质醇水平联合脑电P300预测抑郁症患者发生MCI的ROC曲线下面积为0.91。结论 血清Hcy水平、血清皮质醇水平和脑电P300与抑郁症患者MCI的发生密切相关,三者联合可用于预测抑郁症患者MCI的发生。

Objective To investigate the predictive value of serum homocysteine(Hcy),and cortisol(Cor),and EEG P300 for mild cognitive impairment(MCI)in patients with depression.Methods A total of 156 depressed patients were prospectively collected and followed up for 1 year,during which the neuropsychological functions of the patients were assessed using the Hamilton depression scale(HAMD)-17 items and the Montreal cognitive assessment scale(Mo-CA)every 3 months.Patients were categorized into MCI group and non-MCI group according to whether they occurred MCI or not.EEG P300,and serum Hcy level and serum Cor level were detected.Logistic regression analysis was used to screen the influencing factors of the occurrence of MCI in depressed patients.The predicting value of serum Hcy level,se-rum Cor level and EEG P300 in the occurrence of MCI in depressed patients was evaluated by ROC curve.Results The logistic regression analysis showed that lower serum Hcy level,serum Cor level,and EEG P300 were all protective factors for the occurrence of MCI in depressed patients(OR=0.71,0.87,0.87,P<0.05).ROC curve analysis showed that the area under the ROC curve for serum Hcy level,serum Cor level combined with EEG P300 to predict the occurrence of MCI in depressed patients was 0.91.Conclusion Serum Hcy level,serum Cor level and EEG P300 are closely relat-ed to the occurrence of MCI in depressed patients,and the combination of the three can be used to predict the occur-rence of MCI in depressed patients.