血清白细胞介素-2和白细胞介素-4水平与卒中后抑郁的相关性  

Correlation between the levels of serum interleukin-2 and interleukin-4 and post stroke depression

作　　者：张乾坤 王昊亮 许帅 宋景贵[1] ZHANG Qian-kun;WANG Hao-liang;XU Shuai;SONG Jing-gui(Department of Neurology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院神经内科,河南卫辉453100

出　　处：《新乡医学院学报》2019年第1期28-32,共5页Journal of Xinxiang Medical University

基　　金：国家自然科学基金资助项目(编号:81471349)

摘　　要：目的探讨急性脑梗死(ACI)患者早期血清白细胞介素-2(IL-2)和白细胞介素-4(IL-4)水平与卒中后抑郁(PSD)的关系。方法选择2018年2月10日至3月10日新乡医学院第一附属医院收治的80例ACI患者为研究对象,所有患者入院后随访3个月,根据汉密尔顿抑郁量表(HAMD)评分将患者分为PSD组(HAMD评分≥8分,n=43)和非PSD组(HAMD评分≤7分,n=37)。43例PSD患者中,轻度PSD 19例(轻度PSD组),中重度PSD 24例(中重度PSD组)。另选择同期进行健康体检者40例为对照组。ACI患者于入院第7天、对照组受试者于体检当日抽取空腹静脉血5 m L,采用酶联免疫吸附法(ELISA)检测血清IL-2和IL-4水平,对各组受试者血清IL-2及IL-4水平进行比较;采用受试者工作特征曲线(ROC)评价血清IL-2和IL-4水平预测PSD的敏感度和特异度,计算Youden指数,确定最佳截断值;采用线性相关分析血清IL-2和IL-4水平与PSD患者HAMD评分的相关性。结果 PSD组和非PSD组患者血清IL-2水平显著低于对照组,IL-4水平显著高于对照组(P <0. 01); PSD组患者血清IL-2水平显著低于非PSD组,IL-4水平显著高于非PSD组(P <0. 01)。中重度PSD组患者血清IL-2水平显著低于轻度PSD组,IL-4水平显著高于轻度PSD组(P <0. 01)。轻度PSD组和中重度PSD组患者NIHSS评分显著高于非PSD组(P <0. 01);中重度PSD组患者NIHSS评分显著高于轻度PSD组(P <0. 01)。ROC曲线分析显示,IL-2曲线下面积为0. 752(95%可信区间:0. 605～0. 899,P <0. 05),IL-2水平为7. 68μg·L-1时获得最大Youden指数0. 487,血清IL-2水平预测PSD的敏感度为75. 0%,特异度为26. 3%。IL-4曲线下面积为0. 706(95%可信区间:0. 541～0. 871,P <0. 05),IL-4水平为38. 38μg·L-1时获得最大Youden指数0. 529,血清IL-4水平预测PSD的敏感度为79. 2%,特异度26. 3%。血清IL-2水平与PSD患者HAMD评分呈显著负相关(r=-0. 773,P <0. 01),血清IL-4水平与PSD患者HAMD评分呈显著正相关(r=0. 764,P <0. 01)。结论 PSD患者血清IL-Objective To investigate the relationship between the levels of serum interleukin-2 (IL-2) and interleukin-4 (IL-4) and post stroke depression (PSD) in patients with acute cerebral infarction (ACI).Methods Eighty patients with ACI in the First Affiliated Hospital of Xinxiang Medical University from February 10 to March 10,2018 were selected as subjects.All patients were followed up for 3 months after admission.According to the Hamilton Depression Scale (HAMD) score,the patients were divided into PSD group (HAMD score≥8,n=43) and non-PSD group (HAMD score≤7,n=37).The 43 PSD patients included 19 patients with mild PSD (mild PSD group) and 24 patients with moderate and severe PSD (moderate-severe PSD group).Another 40 healthy people who underwent physical examination at the same time were selected as the control group.Five milliliters of fasting venous blood was taken from ACI patients on the 7th day after admission and control subjects on the day of physical examination.The levels of serum IL-2 and IL-4 were detected by enzyme-linked immunosorbent assay (ELISA).The levels of serum IL-2 and IL-4 were compared among the groups.The sensitivity and specificity of serum IL-2 and IL-4 levels in predicting PSD were evaluated by receiver operating characteristic curve(ROC),and the Youden index was calculated to determine the best cut-off value.The correlation between the levels of serum IL-2 and IL-4 and HAMD score in PSD patients was analyzed by linear correlation.Results The level of serum IL-2 in the PSD group and non-PSD group was significantly lower than that in the control group,and the level of serum IL-4 was significantly higher than that in the control group (P<0.01).The level of serum IL-2 in the PSD group was significantly lower than that in the non-PSD group,and the level of serum IL-4 was significantly higher than that in the non-PSD group (P<0.01).The level of serum IL-2 in the moderate-severe PSD group was significantly lower than that in the mild PSD group,and the level of serum IL-4 was significantly h

关 键 词：脑卒中 卒中后抑郁 白细胞介素-2 白细胞介素-4 

分 类 号：R743.33[医药卫生—神经病学与精神病学]