预后营养指数和炎症指标与卒中后抑郁的相关性分析  

Analysis of prognostic nutritional index and inflammatory indicators in relation to poststroke depression

作　　者：马维丽[1] 王恩石 高戴娜 关卓[1] Ma Weili;Wang Enshi;Gao Daina;Guan Zhuo(Department of Neurology,the First Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150010,China)

机构地区：[1]哈尔滨医科大学附属第一医院神经内科,黑龙江哈尔滨150010

出　　处：《遵义医科大学学报》2025年第3期280-285,共6页Journal of Zunyi Medical University

基　　金：黑龙江省卫生健康委基金资助项目(NO:2020-104)。

摘　　要：目的 评估预后营养指数(PNI)和炎症指标与卒中后抑郁(PSD)的相关性。方法 本研究为回顾性分析,研究对象为2020年1月至2024年1月哈尔滨医科大学第一附属医院神经内科治疗的328例脑卒中患者。根据脑卒中发病90 d时是否存在PSD分为PSD组112例(34.15%)和非PSD组216例(65.85%)。采用单因素与多因素Logistic回归分析PSD的独立危险因素,并采用ROC曲线评估PNI联合炎症指标预测PSD的效能,主要评价指标为曲线下面积(AUC)。结果 单因素Logistic回归分析显示,年龄、合并糖尿病的比例、家庭人均月收入水平、NIHSS评分、血小板、IL-6、IL-8、NLR、PNI水平在两组之间的差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄(OR=1.223, 95%CI:1.034~1.445)、NIHSS评分(OR=1.767, 95%CI:1.303~2.395)、IL-6(OR=1.456, 95%CI:1.097~1.933)是PSD的独立危险因素,而PNI是其保护因素(OR=0.619, 95%CI:0.460~0.832)。ROC曲线显示,PNI联合IL-6预测PSD的AUC为0.870(95%CI:0.831~0.908),敏感性为86.61%,特异性为72.22%,预测效能优于单一指标。结论 PNI和IL-6均与PSD的发生密切相关,二者联合应用可早期预测PSD发生风险,从而辅助临床早期识别PSD,并进行早期干预。Objective To assess the correlation of the prognostic nutrition index(PNI)combined with inflammatory indicators with post-stroke depression(PSD).Methods This study was a retrospective analysis of 328 stroke patients treated in the Department of Neurology of the First Affiliated Hospital of Harbin Medical University from January 2020 to January 2024.According to the stroke onset at 90 d the presence of PSD was divided into 112 cases(34.15%)in the PSD group and 216 cases(65.85%)in the non-PSD group.Independent risk factors for PSD were analyzed using univariate and multivariate logistic regression,and the efficacy of PNI combined with inflammatory indexes in predicting PSD was assessed using ROC curves,with AUC as the main evaluation index.Results Univariate logistic regression showed that the differences in the levels of age,proportion of diabetes mellitus,per capita monthly household income,NIHSS score,platelets,IL-6,IL-8,NLR and PNI levels were statistically significant(P<0.05).Multifactorial logistic regression showed that age(OR=1.223,95%CI:1.034-1.445),NIHSS score(OR=1.767,95%CI:1.303-2.395),IL-6(OR=1.456,95%CI:1.097-1.933)were independent risk factors for PSD,whereas PNI was its protective factor(OR=0.619,95%CI:0.460-0.832).The ROC curve showed that PNI combined with IL-6 predicted PSD with an AUC of 0.870(95%CI:0.831-0.908),a sensitivity of 86.61%,and a specificity of 72.22%,which was superior to the predictive efficacy of a single indicator.Conclusion Both PNI and IL-6 are closely related to the occurrence of PSD,and their combined application can predict the risk of PSD early,thus assisting clinical early identification of PSD and early intervention.

关 键 词：卒中 卒中后抑郁 预后营养指数 炎症指标 

分 类 号：R743.3[医药卫生—神经病学与精神病学]