同型半胱氨酸联合高敏C反应蛋白预测卒中后抑郁的价值研究  

The value of homocysteine combined with high-sensitivity C-reactive protein in predicting for post-stroke depression

作　　者：李霞 王厚清 许铁 吴梦迪 李勋 LI Xia;WANG Houqing;XU Tie;WU Mengdi;LI Xun(Emergency Center,the Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221002,China;Jiangsu Provincial Institute of Health Emergency,Xuzhou Medical University,Xuzhou Jiangsu 221002,China)

机构地区：[1]徐州医科大学附属医院急救中心,江苏徐州221002 [2]徐州医科大学江苏省卫生应急研究所,江苏徐州221002

出　　处：《转化医学杂志》2020年第5期280-283,共4页Translational Medicine Journal

摘　　要：目的探讨同型半胱氨酸(homocysteine,Hcy)联合高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)对急性缺血性脑卒中后抑郁(post-stroke depression,PSD)的预测价值及影响PSD发生的危险因素。方法选取徐州医科大学附属医院就诊的急性脑卒中患者110例,患者发病3个月时采用汉密顿抑郁量表(Hamilton Depression Scale,HAMD)将患者分为卒中后抑郁组(PSD组)40例和非卒中后抑郁组(NPSD组)70例。比较两组患者入院24 h内相关实验室检验结果、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)和HAMD评分,采用Logistic回归、Spearman相关性分析和ROC曲线对两组患者的相关数据进行统计分析。结果Hcy和hs-CRP是急性缺血性脑卒中后3个月时发生PSD的独立危险因素;HAMD评分与Hcy(r=0.540,P=0.000)和hs-CRP(r=0.488,P=0.000)呈正相关性;Hcy联合hs-CRP预测PSD的ROC曲线下面积(area under curve,AUC)为0.870,对应的灵敏度和特异度分别为77.5%、78.6%。Hcy联合hs-CRP的AUC高于Hcy(AUC=0.765)或hs-CRP(AUC=0.800)。结论Hcy联合hs-CRP评估PSD发生预测价值大于Hcy或hs-CRP单一指标,临床应充分评估hs-CRP和Hcy水平均较高的脑卒中患者,及早有针对性的干预和治疗。Objective To investigate the predictive value of homocysteine(Hcy)combined with high-sensitivity C-reactive protein(hs-CRP)for post-stroke depression(PSD)in patients with acute ischemic stroke and the risk factors affecting PSD.Methods A total of 110 patients with acute stroke were selected from our hospital.They were divided into two groups:post-stroke depression group(PSD group,n=40)and non-post-stroke depression group(NPSD group,n=70)with Hamilton depression Scale(HAMD)at three months after onset.The laboratory check results within24 hours after admission,National Institute of Health Stroke Scale(NIHSS)score and HAMD score were compared between the two groups.Logistic regression,Spearman correlation analysis and ROC curve were used to analyze the data of the two groups.Results Hcy and hs-CRP were independent risk factors for PSD at three months after acute ischemic stroke.The HAMD score was positively correlated with Hcy(r=0.540,P=0.000)and hs-CRP(r=0.488,P=0.000).Hcy combined with hs-CRP predicted that the area under the ROC curve of PSD was 0.870,and the corresponding sensitivity and specificity were 77.5%and 78.6%.The AUC of Hcy combined with hs-CRP was higher than the that of Hcy(AUC=0.765)or hs-CRP(AUC=0.800).Conclusion The predictive value of Hcy combined with hs-CRP in predicting the occurrence of PSD is greater than that of Hcy or hsCRP.Stroke patients with high levels of hs-CRP and Hcy should be fully evaluated or be given as targeted intervention and treatment as soon as possible.

关 键 词：缺血性脑卒中 同型半胱氨酸 高敏C反应蛋白 卒中后抑郁 

分 类 号：R749.13[医药卫生—神经病学与精神病学]