脑梗死后抑郁患者血清髓过氧化物酶和脂氧素A4的相关研究  

The correlational research of serum myeloperoxidase and lipoxin A4 level in patients with post-cerebral infarction depression

作　　者：李帅[1] 刘波[2] 

机构地区：[1]包头医学院研究生学院,内蒙古包头014040 [2]包头医学院第一附属医院

出　　处：《包头医学院学报》2017年第4期64-67,共4页Journal of Baotou Medical College

摘　　要：目的:探讨脑梗死后抑郁患者体内髓过氧化物酶(myeloperoxidase,MPO)和脂氧素A4(lipoxin A4,LXA4)水平的改变及其临床意义。方法:选取2015年8月至2016年8月在包头医学院第一附属医院神经内科住院确诊为脑梗死的患者80例以及同期体检者40例作为研究对象,使用汉密尔顿抑郁量表(Hamilton Depression Scal,HAMD)(17项版本),采用观察与交谈的方式,于入院当天、病后1周、2周、1月对脑梗死患者评定其心理状态,将其分为脑梗死后抑郁组(post stroke depression,PSD)(n=31)及脑梗死后非抑郁组(n=49),同期体检者作为对照组。收集所有研究对象不同时期的血清,测定其血清超敏C反应蛋白(high sensitive C-reactive protein,Hs CRP)、MPO、LXA4水平,并计算MPO与LXA4比值(M/L)。结果:脑梗死后抑郁组和脑梗死后非抑郁组不同时期的血清Hs CRP、LXA4、MPO水平和M/L均高于对照组(P<0.05);脑梗死后抑郁组MPO水平和M/L均高于脑梗死后非抑郁组(P<0.05);脑梗死后抑郁组中不同时期的MPO与HAMD评分均呈正相关,不同时期的LXA4与HAMD评分均呈负相关(P<0.05)。结论:脑梗死后抑郁的患者体内可能存在较为严重的炎症反应,其机制很可能与促炎因子和抗炎因子之间的动态平衡变化有关。Objective： To investigate the change of serum myeloperoxidase （MPO） and lipoxin A4 （ LXA4 ） in patients with post - cerebral in- farction depression （PCID） and its clinical significance. Methods ： 80 cases of cerebral infarction confirmed in Department of Neurology of The First Affiliated Hospital of Baotou Medical College between August 2015 and August 2016 were enrolled as the study group, and 40 cases undergo- ing physical examination in the same period as the control group. The Hamilton Depression rating scale （HAMD -17） was used to assess the psy- chological state of patients with cerebral infarction, by means of observation and conversation, on the day of admission, the 1st week, the 2nd week, and the lrst month, by which these patients were assigned to a depression group （ n =31 ） or a non - depression group （ n =49）. The ser- um levels of high sensitive C - reactive protein （ Hs - CRP）, MPO, and LXA4 in different periods were examined, and the ratio of MPO and LXA4 （M/L） was calculated. Results： Levels of Hs -CRP, MPO, and LXA4 as well as M/L ratios in different periods in the two cerebral infarction groups were significantly higher than those in the control group （ P 〈0.01 ）. Compared with the non - depression group, levels of MPO and M/L ratios in different periods in the depression group increased （ P 〈 0.05 ）. Correlation analysis showed that levels of MPO in different periods were positively correlated with the score of HAMD, while levels of LXA4 in different periods were negatively correlated with HAMD. Conclusion：The inflammatory response may be aggravated in patients with PCID. The imbalance between inflammation and anti - inflammation may be part of the mechanism.

关 键 词：脑梗死 抑郁 炎症 髓过氧化物酶 脂氧素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]