血清8-OHdG、COR、IL-18水平与卒中后抑郁的关系  

Relationships between serum 8-OHdG,COR,IL-18 levels and post-stroke depression

作　　者：张婷婷 钱静 宗亚雯 ZHANG Tingting;QIAN Jing;ZONG Yawen(Department of Neurology,Taizhou Second People's Hospital,Taizhou China)

机构地区：[1]泰州市第二人民医院神经内科,江苏泰州225500

出　　处：《山东医药》2024年第16期24-28,共5页Shandong Medical Journal

基　　金：江苏省中西医结合老年病防治重点实验室开放课题(202206)。

摘　　要：目的探讨血清8-羟基脱氧鸟苷酸(8-OHdG)、皮质醇(COR)、白细胞介素18(IL-18)水平与卒中后抑郁的关系。方法选取缺血性卒中患者272例,根据汉密尔顿抑郁量表(HAMD)评分将患者分为非抑郁组170例、抑郁组102例,其中,7分≤HAMD评分<17分为轻度抑郁、17分≤HAMD评分<24分为中度抑郁、HAMD评分总分≥24分为重度抑郁。收集患者的相关资料,用美国国立卫生研究院卒中量表(NIHSS)评分评估患者神经功能受损情况,用日常生活活动能力(ADL)评分评估患者生活能力,用双抗体酶联免疫吸附法检测血清8-OHdG、COR、IL-18。用Logistic多因素回归(进入法)分析卒中后抑郁的影响因素;用受试者工作特征(ROC)曲线评估各指标对卒中后抑郁的预测效能。结果与非抑郁组比较,抑郁组独居比例、负性生活事件发生率、NIHSS评分及血清8-OHdG、COR、IL-18水平高,而ADL评分低,比较差异均有统计学意义(P均<0.05)。8-OHdG、COR、IL-18、NIHSS评分均为卒中后抑郁的影响因素(P均<0.05)。重度抑郁患者血清8-OHdG、COR、IL-18水平高于轻度、中度抑郁患者(P均<0.05),中度抑郁患者血清8-OHdG、COR、IL-18水平高于轻度抑郁患者(P均<0.05)。8-OHdG、COR、IL-18联合预测卒中后抑郁的ROC曲线下面积大于三者单独预测(P均<0.05)。结论卒中后抑郁患者血清中8-OHdG、COR、IL-18水平升高,三者水平变化可反映病情严重程度,三者联合检测对卒中后抑郁有较高的预测价值。Objective To explore the relationships between serum levels of 8-hidroxy-2-deoxyguanosine(8-OHdG),cortisol(COR),interleukin-18(IL-18)and post-stroke depression.Methods A total of 272 patients with ischemic stroke were selected and divided into the non-depression group(170 cases)and depression group(102 cases)according to Hamilton Depression Rating Scale(HAMD)scores.Among them,7≤HAMD score<17 was classified as the mild depres-sion,17≤HAMD score<24 was classified as the moderate depression,and HAMD score≥24 was classified as the severe depression.The relevant data of the patients were collected,the National Institutes of Health Stroke Scale(NIHSS)score was used to evaluate the neurological impairment of the patients,the activities of daily living(ADL)was used to evaluate the living ability of the patients,and the serum 8-OHdG,COR,and IL-18 were detected by double antibody enzyme-linked immunosorbent assay.Logistic multiple factor regression(entry method)was used to analyze the influencing factors of post-stroke depression.The predictive efficacy of various indicators for post-stroke depression was evaluated using receiver operating characteristic(ROC)curves.Results Compared with the non-depression group,the proportion of liv-ing alone,the incidence of negative life events,NIHSS score and serum levels of 8-OHdG,COR and IL-18 in the depres-sion group were higher,while the ADL score was lower,and the differences were statistically significant(all P<0.05).The 8-OHdG,COR,IL-18 and NIHSS score were the influencing factors of post-stroke depression(all P<0.05).The serum levels of 8-OHdG,COR and IL-18 in patients with severe depression were higher than those in patients with mild and moderate depression(all P<0.05),and the serum levels of 8-OHdG,COR and IL-18 in patients with moderate depression were higher than those in patients with mild depression(all P<0.05).The area under the ROC curve of the combination of 8-OHdG,COR,and IL-18 in predicting post-stroke depression was larger than that of the three alone(all P<0.

关 键 词：抑郁 脑卒中 8-羟基脱氧鸟苷酸 皮质醇 白细胞介素18 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R743.33[医药卫生—临床医学]