益生菌制品消费与缺血性卒中患者血清炎性细胞因子、内毒素和卒中后抑郁严重程度的相关性

Correlation of probiotic consumption with serum inflammatory cytokines,endotoxin and post-stroke depression severity in patients with ischemic stroke

目的探讨缺血性卒中患者益生菌制品消费水平与血清炎性细胞因子、内毒素以及卒中后抑郁(post-stroke depression,PSD)严重程度的相关性。方法前瞻性纳入2021年5月至2022年6月在海军军医大学第三附属医院神经内科就诊的缺血性卒中患者。在出院后6个月时进行门诊随访,调查过去半年内益生菌制品消费情况,并应用抑郁自评量表(Self-rating Depression Scale,SDS)进行抑郁评估。采用多元线性回归分析确定益生菌制品消费水平与血清炎性细胞因子、内毒素以及PSD严重程度的相关性。结果共纳入168例缺血性卒中患者,益生菌制品高消费组74例(44.0%),低消费组94例(56.0%)。高消费组PSD发生率显著低于低消费组(22.97%对38.30%;χ^(2)=6.551,P=0.036)。高消费组随访时血清促炎性细胞因子白细胞介素(interleukin,IL)-6和内毒素显著低于低消费组,而抗炎性细胞因子IL-10显著高于低消费组(P均<0.05)。多元线性回归分析显示,益生菌消费水平与随访时血清IL-6(β=-0.178,P=0.001)及内毒素(β=-0.107,P=0.035)呈显著负相关;PSD严重程度(SDS评分)与益生菌消费水平呈显著负相关(β=-0.309,P=0.001),与随访时IL-6(β=0.306,P=0.027)及内毒素(β=0.360,P=0.017)呈显著正相关。结论益生菌制品可降低血清促炎性细胞因子、内毒素以及PSD严重程度,可能是PSD的非药物治疗方向。

Objective To investigate the correlation of probiotic consumption level with serum inflammatory cytokines,endotoxin and post-stroke depression(PSD)severity in patients with ischemic stroke.Methods Patients with ischemic stroke visited the Department of Neurology,the Third Affiliated Hospital of Naval Medical University from May 2021 to June 2022 were prospectively included.At 6 months after discharge,the outpatient follow-up was conducted to investigate the consumption of probiotic products in the past six months,and depression was evaluated using the Self-rating Depression Scale(SDS).Multiple linear regression analysis was used to determine the correlation of consumption levels of probiotic products and serum inflammatory cytokines,endotoxin,and PSD severity.Results A total of 168 patients with ischemic stroke were included,including 74 patients(44.0%)in the probiotic product high consumption group and 94(56.0%)in the low consumption group.The incidence of PSD in the high consumption group was significantly lower than that in the low consumption group(22.97%vs.38.30%;χ^(2)=6.551,P=0.036).The serum pro-inflammatory cytokine interleukin-6(IL-6)and endotoxin levels at the follow-up in the high consumption group were significantly lower than those in the low consumption group,while the anti-inflammatory cytokine IL-10 was significantly higher than that in the low consumption group(all P<0.05).Multiple linear regression analysis shows that the probiotic consumption level was significantly negatively correlated with the serum IL-6(β=-0.178,P=0.001)and endotoxin(β=-0.107,P=0.035)at follow-up.PSD severity(SDS score)was negatively correlated with probiotic consumption level(β=-0.309,P=0.001),and was positively correlated with IL-6(β=0.306,P=0.027)and endotoxin(β=0.360,P=0.017)at follow-up.Conclusion Probiotic products can reduce the severity of serum pro-inflammatory cytokines,endotoxin and PSD,and may be a non-drug treatment direction for PSD.