高原地区卒中后抑郁与睡眠质量和炎性因子关系研究  

Relation of Acute Post-stroke Depression &Sleep Quality and Inflammatory Factors at High Altitude

作　　者：铁婷婷 王兰桂[1] 张璟[1] 黄茜[1] 旦祥 杨占银 

机构地区：[1]青海大学附属医院,810001 [2]青海省海南州人民医院,813000

出　　处：《高原医学杂志》2017年第2期1-4,共4页Journal of High Altitude Medicine

基　　金：青海大学中青年科研基金项目(基金编号:2014-QYY-9)

摘　　要：目的:观察高原地区脑卒中后抑郁(PSD)的发生与患者睡眠质量和血清IL-6、TNF-α、hs-CRP水平关系。方法:收集世居海南州地区(海拔约3 000m)住院急性脑出血及动脉粥样硬化性脑梗死资料完整的汉族患者60例和同期健康汉族体检者30例作为观察对象,记录患者和体检者的有关临床资料,同时进行汉密尔顿抑郁量表(HDRS17)、睡眠质量(PSQI)评分,采用酶联免疫分析法、散射比浊法分别测定患者和体检者血清中IL-6、TNF-α和hs-CRP水平。根据DSM^IV抑郁症诊断标准,将患者分为抑郁组和非抑郁组,体检者为对照组,比较3组HDRS17、PSQI评分和血清中IL-6、TNF-α和hs-CRP水平。结果:急性期PSD发生率为26.7%,男女间PSD发生率比较有统计学差异(P<0.05)。3组HDRS17评分比较,PSD组>非PSD组,差异具有统计学意义(P<0.05),3组PSQI评分比较,PSD组>非PSD组>对照组,差异具有统计学意义(P<0.05),3组血清hs-CRP、IL-6水平比较,PSD组>非PSD组>对照组,差异具有统计学意义(P<0.05),3组血清TNF-α水平比较,PSD组>非PSD组,PSD组>对照组,差异具有统计学意义(P<0.05)。结论:高原地区卒中患者急性期PSD发生率较高,女性易患,睡眠质量和炎症反应影响PSD发生。Objective：This study will observe the relation of acute post--stroke depression（PSD）, sleep- ing quality, serum level of IL-- 6, TNF-- αand hs-- CRP at high altitude.Methods： We selected 60 native Han nationality patients with acute cerebral hemorrhage ,atheroselerotic cerebral infarction and 30 volun- teers in the healthy center at the same period from Hainan Tibetan Autonomous Prefecture Hospital（about 3 000m height）, and relative clinical data were collected. At the same time, HDRS17 and PSQI were scored while Nephelometry and ELISA were used to determine the concentration of serum hs--CRP, IL--6 and TNF-α respectively. Patients were divided into PSD and non--PSD group according to depression diag- nostic criterion of DSM--IV, and volunteers were determined as control group. The scores of HDRS17 and PSQI, serum level of IL--6,TNF-α and hs--CRP were analyzed and compared among 3 groups.Results： Incidence rate of PSD was 26.7%. Compared with incidence rate of PSD of different gender , the differ- ences bad statistical significance （P 〈 0.05）. Compared with score of HDRS17, PSD group 〉 non-- PSD group, the differences had statistical signifieance（P〈0.05）. Compared with score of PSQI, PSD group〉non--PSD group〉control group, the differences had statistical significance（P〈0.05）.Compared with ser- um level of hs--CRP, IL--6 , PSD group〉non--PSD group〉control group, the differences had statisti- cal significance（P 〉0.05）.Compared with serum level of TNF-α, PSD group〉 non -- PSD group, and PSD group〉eontrol group, the differences had statistical significance（P 〈0.05）.Conclusions：Incidence rate of PSD at high altitude is relatively high, especially for females, and inflammation and sleeping quality in- fluence the factors of acute PSD.

关 键 词：抑郁 高原 炎性因子 睡眠障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R339.54[医药卫生—临床医学]