血清5-羟色胺水平与卒中后抑郁的关系研究

Study on the Relationship Between Serum 5-hydroxytryptamine Level and Post-stroke Depression

目的探讨血清5-羟色胺(5-HT)水平与卒中后抑郁(PSD)的关系。方法选取2021年6月-2022年11月桂林医学院附属医院神经内科住院的急性缺血性脑卒中患者103例,根据精神障碍诊断和统计手册第5版中抑郁症的诊断标准,结合HAMD-17和PHQ-9进行辅助诊断,将患者分为4组:A组是基线期和随访时均存在明显抑郁情绪,均符合PSD标准;B组是基线期符合PSD标准,随访时抑郁情绪已恢复但不符合PSD标准;C组是基线期不符合PSD标准,随访时出现抑郁情绪符合PSD标准;D组是基线期和随访时均无抑郁情绪,不符合PSD标准。比较4组临床资料,并采用二元Logistic回归分析探讨各因素对PSD的贡献作用,ROC曲线分析5-HT和NIHSS评分预测PSD发生的诊断效能。结果4组性别、年龄、HCY、LDL、空腹血糖和NIHSS评分比较,差异无统计学意义(P>0.05),而四组HAMD-17基线、PHQ-9-基线、HAMD-17随访、PHQ-9-随访、5-HT水平比较,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,NIHSS评分和血清5-HT水平是PSD的独立预测风险因子。ROC曲线分析显示,5-HT和NIHSS评分联合诊断PSD的预测价值良好(曲线下面积为0.817,95%置信区间为0.728~0.906,P<0.05)。结论血清5-HT水平与PSD关系密切,能较为准确的预测PSD的发生。

Objective To investigate the relationship between serum 5-hydroxytryptamine(5-HT)level and post-stroke depression(PSD).Methods A total of 103 patients with acute ischemic stroke who were hospitalized in the Department of Neurology,Affiliated Hospital of Guilin Medical College from June 2021 to November 2022 were selected.According to the diagnostic criteria of depression in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders,combined with HAMD-17 and PHQ-9 for auxiliary diagnosis,the patients were divided into four groups:group A had obvious depression at baseline and follow-up,which met the PSD criteria;in group B,the baseline period met the PSD standard,and the depression recovered but did not meet the PSD standard at follow-up;in group C,the baseline period did not meet the PSD standard,and the depression during follow-up was in line with the PSD standard;group D had no depression at baseline and follow-up,which did not meet the PSD criteria.The clinical data of the four groups were compared,and the contribution of each factor to PSD was explored by binary Logistic regression analysis.ROC curve was used to analyze the diagnostic efficacy of 5-HT and NIHSS scores in predicting PSD.Results There were no significant differences in gender,age,HCY,LDL,fasting blood glucose and NIHSS scores among the four groups(P>0.05),while there were significant differences in HAMD-17 baseline,PHQ-9-baseline,HAMD-17 follow-up,PHQ-9-follow-up and 5-HT levels among the four groups(P<0.05).Binary Logistic regression analysis showed that NIHSS score and serum 5-HT level were independent predictors of PSD.ROC curve analysis showed that the predictive value of 5-HT combined with NIHSS score in the diagnosis of PSD was good(area under the curve was 0.817,95%confidence interval was 0.728-0.906,P<0.05).Conclusion Serum 5-HT level is closely related to PSD and can accurately predict the occurrence of PSD.