血清IL-6、IL-1β、NLR联合NIHSS评分预测卒中后患者发生抑郁障碍的价值  

The Value of Serum IL-6,IL-1β,and NLR Combined with NIHSS Scores in Predicting the Occurrence of Depressive Disorders in Patients after Stroke

作　　者：王龙 方丽君 江玲玲 林岐 WANG Long;FANG Lijun;JIANG Lingling;LIN Qi(Emergency Department of Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Municipal Hospital,Suzhou,Jiangsu 215000,China;Department of Neurology,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou Municipal Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院急诊科,江苏苏州215000 [2]南京医科大学附属苏州医院苏州市立医院神经内科,江苏苏州215000 [3]苏州市急救中心

出　　处：《转化医学杂志》2024年第11期1969-1973,共5页Translational Medicine Journal

基　　金：苏州市科技计划项目(SS202072)。

摘　　要：目的探讨血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、中性粒细胞/淋巴细胞比值(NLR)联合美国国立卫生研究院卒中量表(NIHSS)评分预测卒中后抑郁障碍(PSD)的应用价值。方法选取180例首次发病的卒中患者,根据是否发生PSD分为PSD组(44例)、非PSD组(136例)。收集患者临床资料,血清IL-6、IL-1β、NLR水平及NIHSS评分。采用单因素分析及多因素logistic回归分析PSD的危险因素,并通过受试者工作特征曲线(ROC)评估上述指标对PSD的预测效能。结果经单因素分析,两组高血压、家庭人均月收入、血清IL-6、IL-1β、NLR水平及NIHSS评分差异均有统计学意义(P<0.05)。经logistic回归分析,血清IL-6、IL-1β、NLR水平及NIHSS评分升高是PSD的独立影响因素(OR>1,P<0.05)。经ROC分析,当血清IL-6≥20.210 pg/mL时,预测PSD的灵敏度为77.3%,特异度为77.2%;当IL-1β≥30.025 pg/mL时,灵敏度为72.7%,特异度为75.0%;当NLR≥3.365时,灵敏度为70.5%,特异度为75.7%;当NIHSS评分≥15.50分时,灵敏度为68.2%,特异度为73.5%;四者联合预测PSD的曲线下面积(AUC)为0.853,灵敏度为79.5%,特异度为82.4%,优于单一指标的预测效能。结论血清IL-6、IL-1β、NLR水平及NIHSS评分升高与PSD的发生密切相关。联合应用上述4项指标可显著提高对PSD的预测效能。Objective To explore the application value of serum interleukin-6(IL-6),interleukin-1β(IL-1β),neutrophil-to-lymphocyte ratio(NLR)combined with the National Institutes of Health Stroke Scale(NIHSS)score in predicting post-stroke depression(PSD).Methods A total of 180 patients with a first-time stroke were selected and divided into the PSD group(44 cases)and the non-PSD group(136 cases)based on the occurrence of PSD.Clinical data was collected,including serum levels of IL-6,IL-1β,NLR,and NIHSS scores.Univariate analysis and multivariate logistic regression were employed to identify risk factors for PSD,and the predictive efficacy of the aforementioned indicators for PSD was assessed using receiver operating characteristic curves(ROC).Results Univariate analysis revealed statistically significant differences in hypertension,family monthly income per capita,serum levels of IL-6,IL-1β,NLR,and NIHSS scores between the two groups(P<0.05).Logistic regression analysis indicated that elevated serum levels of IL-6,IL-1β,NLR,and NIHSS scores are independent risk factors for PSD(OR>1,P<0.05).ROC analysis showed that when serum IL-6≥20.210 pg/mL,the sensitivity for predicting PSD was 77.3%and the specificity was 77.2%;when IL-1β≥30.025 pg/mL,the sensitivity was 72.7%and the specificity was 75.0%;when NLR≥3.365,the sensitivity was 70.5%and the specificity was 75.7%;and when NIHSS score≥15.50,the sensitivity was 68.2%and the specificity was 73.5%.The area under the curve(AUC)for the combined prediction of PSD by the four indicators was 0.853,with a sensitivity of 79.5%and a specificity of 82.4%,which was superior to the predictive efficacy of any single indicator.Conclusion Elevated serum levels of IL-6,IL-1β,NLR,and NIHSS scores are closely associated with the occurrence of PSD.The combined use of these four indicators can significantly enhance the predictive efficacy for PSD.

关 键 词：卒中后抑郁障碍 白细胞介素-6 白细胞介素-1Β 中性粒细胞/淋巴细胞比值 NIHSS评分 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]