缺血性脑卒中患者白细胞线粒体膜电位和线粒体呼吸链复合体活性变化及其与卒中后抑郁的关系  

Changes of leukocyte mitochondrial membrane potential and activities of mitochondrial respiratory chain complexes in patients with ischemic stroke and its correlation with post-stroke depression

作　　者：任长安 戚游 汪文娟 REN Changan;QI You;WANG Wenjuan(Department of Neurology,Affiliated Hospital of West Anhui Health Vocational College,Lu'an Anhui 237008,China;不详)

机构地区：[1]皖西卫生职业学院附属医院神经内科,237008

出　　处：《中国神经免疫学和神经病学杂志》2023年第3期180-185,190,共7页Chinese Journal of Neuroimmunology and Neurology

基　　金：安徽省教育厅自然基金资助项目(编号:KJ2012A175)。

摘　　要：目的研究缺血性脑卒中(ischemic stroke,IS)患者白细胞线粒体膜电位和线粒体呼吸链复合体Ⅰ~Ⅳ活性的变化,并探讨其与卒中后抑郁(post-stroke depression,PSD)的关系。方法前瞻性收集2018年11月至2020年7月作者医院收治的IS患者189例,其中男112例,女77例。均给予个体化治疗后随访1年。随访1年时采用汉密尔顿抑郁量表(HAMD)评估PSD严重程度,并根据HAMD评分将患者分为PSD组(HAMD≥8分)和非PSD组(HAMD<8分)。分别于入院第1天和随访结束时检测患者白细胞线粒体膜电位及呼吸链复合体Ⅰ~Ⅳ活性水平变化,分析白细胞线粒体膜电位及呼吸链复合体Ⅰ~Ⅳ活性水平与PSD严重程度的相关性及其对IS患者发生PSD的预测价值。结果189例IS患者完成随访182例,其中共发生PSD 73例(40.11%)。与非PSD组比较,PSD组入院第1天时白细胞线粒体膜电位及呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ活性降低(均P<0.05),随访1年时两组白细胞线粒体膜电位及呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ活性均较入院第1天时升高(P<0.05),而两组间比较差异均无统计学意义(P>0.05)。轻度(n=29)、中度(n=26)及重度(n=18)PSD患者入院第1天时白细胞线粒体膜电位及呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ活性间比较差异均有统计学意义,且随PSD严重程度增加而降低(P<0.05)。Pearson积差分析显示,PSD患者HAMD评分与入院第1天时白细胞线粒体膜电位及呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ活性均呈明显负相关(r=-0.492、-0.507、-0.428、-0.617、-0.546,均P<0.05)。ROC分析显示入院第1天时白细胞线粒体膜电位及呼吸链复合体Ⅰ、Ⅱ、Ⅲ、Ⅳ活性预测IS患者发生PSD的AUC分别为0.606、0.734、0.816、0.747和0.690(均P<0.05)。结论PSD患者入院第1天白细胞线粒体膜电位及呼吸链复合体Ⅰ~Ⅳ活性降低可能在PSD发病和进展过程中发挥重要作用,其在预测PSD的发病中具有一定参考价值。Objective To study the changes of leukocyte mitochondrial membrane potential and activities of mitochondrial respiratory chain complexesⅠ-Ⅳin patients with ischemic stroke(IS),and to explore its correlation with post-stroke depression(PSD).Methods One hundred and eighty-nine patients with IS in the hospital between November 2018 and July 2020 were prospectively collected,including 112 males and 77 females.All patients were followed up for 1 year after individualized treatment,and Hamilton Depression Scale(HAMD)was used to assess the PSD severity.According to HAMD score,the patients were divided into PSD group(HAMD≥8 points)and non-PSD group(HAMD<8 points).The changes in leukocyte mitochondrial membrane potential and respiratory chain complexesⅠ-Ⅳactivities were detected on the first day(1 st)of admission and at the end of follow-up.The correlation of leukocyte mitochondrial membrane potential and activities of respiratory chain complexesⅠ-Ⅳwith severity of PSD and the predictive value on PSD in patients with IS were analyzed.Results Among 189 patients with IS,182 cases completed the follow-up,of which 73 cases occurred PSD(40.11%).The leukocyte mitochondrial membrane potential and respiratory chain complexesⅠ,Ⅱ,ⅢandⅣactivities in PSD group on the 1 st d of admission were lower than those in non-PSD group(all P<0.05).At 1 year of follow-up,the leukocyte mitochondrial membrane potential and activities of respiratory chain complexesⅠ,Ⅱ,ⅢandⅣwere significantly increased in the two groups compared with those on the 1 st d of admission(P<0.05),but the differences between the two groups were not statistically significant(P>0.05).The leukocyte mitochondrial membrane potential and activities of respiratory chain complexesⅠ,Ⅱ,ⅢandⅣwere significantly different among patients with mild(n=29),moderate(n=26)and severe(n=18)PSD on the 1 st d after admission and were all decreased with the aggravation of PSD severity(P<0.05).Pearson product-moment correlation showed that the HAMD score of pa

关 键 词：卒中 脑缺血 抑郁 膜电位 线粒体 呼吸链复合体 白细胞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]