白细胞介素10和过氧化氢酶对急性缺血性卒中病人卒中后抑郁的预测价值  

Predictive value of interleukin-10 and catalase for post-stroke depression in patients with acute ischemic stroke

作　　者：李清金[1] 张泽 江华[1] 洪春永[1] LI Qingjin;ZHANG Ze;JIANG Hua;HONG Chunyong(Department of Neurology,Southeast Hospital Affiliated to Xiamen University,909 Hospital,Xiamen Fujian 363000,China;Department of Critical Care,Southeast Hospital Affiliated to Xiamen University,909 Hospital,Xiamen Fujian 363000,China)

机构地区：[1]厦门大学附属东南医院,第909医院神经内科,福建厦门363000 [2]厦门大学附属东南医院,第909医院重症医学科,福建厦门363000

出　　处：《蚌埠医学院学报》2024年第2期215-220,共6页Journal of Bengbu Medical College

基　　金：联勤保障部队第909医院青年苗圃基金项目(20YQ010)。

摘　　要：目的:探讨白细胞介素10(IL-10)和过氧化氢酶(CAT)对急性缺血性卒中病人卒中后抑郁(PSD)的预测价值。方法:151例急性缺血性卒中病人入院后24 h内测定血清IL-10、CAT水平。使用17项汉密尔顿抑郁量表(HAMD-17)来评估抑郁症状;PSD定义为HAMD评分≥8。结果:脑梗死后1个月开始随访,有51例(33.8%)被诊断为PSD。与非PSD病人相比,PSD组入院和出院时NIHSS评分较高,脑梗死体积较大,BI评分较低,mRS评分较高,血清CAT、IL-10水平较低(P<0.05)。在调整了潜在混杂因素(在单变量逻辑回归分析中,P<0.05)后,IL-10(OR=0.615,95%CI:0.410~0.923)和CAT(OR=0.757,95%CI:0.652~0.914)仍然是PSD的独立预测因子。PSD病人的IL-10水平(r=0.394,P<0.01)和CAT水平(r=0.306,P<0.01)与HAMD评分呈负相关。ROC分析显示,血清IL-10水平的截止点为2.06 pg/mL,预测PSD的AUC为0.739。同时,CAT水平的截止点为1.07 U/L,预测PSD的AUC为0.630。IL-10水平较低(<2.06 pg/mL)的病人比对应组(≥2.06 pg/mL)更容易发生PSD(OR=9.750,95%CI=2.671~35.534,P<0.01)。同样,CAT水平较低(<1.07 U/L)的病人比对应组(≥1.07 U/L)更容易发生PSD(OR=5.052,95%CI=1.256~20.322,P<0.05)。结论:血清IL-10、CAT可用作急性缺血性卒中病人PSD的独立保护性预测因子。IL-10、CAT水平低的病人在卒中后1个月更有可能发生PSD。Objective:To investigate the predictive value of interleukin-10(IL-10)and catalase(CAT)in post-stroke depression(PSD)in patients with acute ischemic stroke.Methods:Serum IL-10 and CAT levels in 151 patients with acute ischemic stroke within 24 h of hospital admission were measured.Depressive symptoms were assessed using the 17-item Hamilton depression scale(HAMD-17),and PSD was defined as a HAMD score≥8.Results:At 1-month follow-up after stroke,51(33.8%)patients were diagnosed with PSD.Compared with non-PSD patients,the PSD group had higher NIHSS scores at admission and discharge,larger cerebral infarction volume,lower BI score,higher mRS score,and lower serum CAT and IL-10 levels(P<0.05).After adjusting for potential confounders(P<0.05 in univariate logistic regression analysis),IL-10(OR=0.615,95%CI:0.410-0.923)and CAT(OR=0.757,95%CI:0.652-0.914)were independent predictors of PSD.IL-10 levels(r=0.394,P<0.01)and CAT levels(r=0.306,P<0.01)were negatively correlated with HAMD scores in PSD patients.ROC analysis showed that the cutoff point for serum IL-10 levels was 2.06 pg/mL,and the AUC for predicting PSD was 0.739.Meanwhile,the cutoff point for the CAT level was 1.07 U/L,and the AUC for predicting PSD was 0.630.Patients with lower IL-10 levels(<2.06 pg/mL)were more likely to develop PSD than their counterparts(≥2.06 pg/mL)(OR=9.750,95%CI=2.671-35.534,P<0.01).Meanwhile,patients with lower CAT levels(<1.07 U/L)were more likely to develop PSD than their counterparts(≥1.07 U/L)(OR=5.052,95%CI=1.256-20.322,P<0.05).Conclusions:Serum IL-10 and CAT can be used as independent protective predictors of PSD in patients with acute ischemic stroke.Patients with low levels of IL-10 and CAT are more likely to develop PSD 1 month after stroke.

关 键 词：急性缺血性卒中 白细胞介素10 过氧化氢酶 卒中后抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学]