经颅超声联合血清Hcy hs-CRP水平对早期脑卒中后抑郁的预测价值  

The predictive value of transcranial sonography combined with serum Hcy and hs-CRP level for early post-stroke depression

作　　者：肖露 王华[1] 姬亚杰 Xiao Lu;Wang Hua;Ji Yajie(Luoyang Central Hospital,Luoyang 471000,Henan,China)

机构地区：[1]洛阳市中心医院,河南洛阳471000

出　　处：《临床心身疾病杂志》2025年第2期1-5,共5页Journal of Clinical Psychosomatic Diseases

基　　金：洛阳市医疗卫生指导性科技计划项目(编号2302042Y);河南省医学科技攻关计划联合共建项目(编号LHGJ20210869)。

摘　　要：目的 探讨经颅超声(TCS)联合血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平对早期脑卒中后抑郁(PSD)的预测价值。方法 回顾性选取160例脑卒中患者为研究对象,收集患者相关一般资料。采用TCS检测患者中缝核、黑质回声是否异常,并检测患者血清Hcy、hs-CRP水平;采用Kappa值对中缝核超声、黑质超声与PSD诊断标准进行一致性分析;采用多因素Logistic回归分析探讨早期PSD发生的影响因素;采用受试者工作特征(ROC)曲线分析TCS、血清Hcy、hs-CRP水平及三者联合对脑卒中患者早期PSD的预测价值。结果 160例脑卒中患者中,42例患者发生PSD,设为PSD组;118例患者未发生PSD,设为非PSD组。PSD组患者血清Hcy、hs-CRP水平高于非PSD组(P<0.01);多因素Logistic分析结果显示,血清Hcy、hs-CRP水平及中缝核超声异常是脑卒中患者早期发生PSD的危险因素(P<0.01)。ROC曲线结果显示,中缝核超声、血清Hcy、hs-CRP水平及三者联合预测脑卒中患者早期PSD发生的曲线下面积(AUC)分别为0.726、0.881、0.839、0.956;三者联合预测优于单独预测(P<0.01)。结论 经颅超声联合血清Hcy、hs-CRP水平对早期PSD发生的预测价值较高,有一定的临床应用价值。Objective To explore the predictive value of transcranial sonography(TCS)combined with serum homocysteine(Hcy)and high-sensitivity C-reactive protein(hs-CRP)level for early post-stroke depression(PSD).Methods A total of 160 stroke patients were retrospectively selected as research objects and their general data collected.The TCSs were performed to check whether raphe nuclei and substantia nigra echo were abnormal and serum Hcy and hs-CRP levels detected in patients.The Kappa value was used to analyze the consistency between raphe nuclei and substantia nigra ultrasound and PSD diagnostic criteria.Multi-factor Logistic regression analysis was used to explore factors affecting the occurrence of early PSD;The receiver operating characteristic(ROC)curve was used to analyze the predictive values of TCS,Hcy,hs-CRP and their combination for early PSD of the patients.Results Of 160 stroke patients,42 ones developed PSD and were set as PSD group;118 ones didn't develop PSD and were set as non-PSD group.Serum Hcy and hs-CRP level were higher in PSD than non-PSD group(P<0.01);multi-factor Logistic regression analysis showed that serum Hcy and hs-CRP level and ultrasound abnormalities in raphe nuclei were risk factors of early occurrence of PSD in stroke patients(P<0.01).The ROC results showed that the areas under the ROC curve of raphe nuclei ultrasound,Hcy,hs-CRP and their combination predicting early PSD were 0.726,0.881,0.839 and 0.956 respectively,the prediction of the three combination was superior to single prediction(P<0.01).Conclusion TCS combined with serum Hcy and hs-CRP level has a higher predictive value for the occurrence of early PSD and a certain clinical application value.

关 键 词：经颅超声 同型半胱氨酸 超敏C反应蛋白 脑卒中后抑郁 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]