炎性因子与脑卒中后抑郁关联性的Meta分析  

Meta analysis of association between inflammatory factors and post-stroke depression

作　　者：刘欢 叶勇强 薛芳 吕建伟 刘红彬 Liu Huan;Ye Yongqiang;Xue Fang;Lyu Jianwei;Liu Hongbin(Department of Neurosurgery,Ziyang Central Hospital,Ziyang 641300,China)

机构地区：[1]资阳市中心医院神经外科,资阳641300

出　　处：《中华神经医学杂志》2025年第3期267-274,共8页Chinese Journal of Neuromedicine

摘　　要：目的系统评价C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平与脑卒中后抑郁(PSD)的关联性。方法应用计算机检索PubMed、Embase、the Cochrane library、Web of Science、中国知网、万方数据库,收集比较PSD和非PSD患者外周血CRP、IL-6和TNF-α水平的相关文献,检索时限均为建库至2024年10月。按照纳排标准进行文献筛选,并从文献中提取数据,采用纽卡斯尔-渥太华量表(NOS)对纳入文献进行质量评价。运用Stata 18.0软件进行Meta分析,并进行发表偏倚评估。结果共纳入21项文献,包含3177例患者,其中PSD组患者1425例,非PSD组患者1752例。Meta分析结果显示,PSD组患者外周血CRP水平高于非PSD组患者[标准化均数差(SMD)=0.930,95%CI:0.580~1.280,P<0.001]。亚组分析结果显示,在CRP检测时间为脑卒中后14 d内的7项研究中,PSD组患者外周血CRP水平高于非PSD组患者(SMD=0.640,95%CI:0.380~0.890,I 2=83.9%,P<0.001);在CRP检测时间为脑卒中后14 d或之后的4项研究中,PSD组患者外周血CRP水平显著高于非PSD组患者(SMD=1.450,95%CI:0.820~2.090,P<0.001),且伴随更高的异质性(I 2=90.6%)。PSD组患者外周血IL-6水平显著高于非PSD组患者(SMD=2.659,95%CI:1.583~3.735,P<0.001)。PSD组与非PSD组患者外周血TNF-α水平的差异无统计学意义(SMD=0.403,95%CI:-0.208~1.014,P=0.196)。结论PSD患者外周血CRP和IL-6水平显著高于非PSD患者,提示外周血CRP和IL-6可能为PSD早期识别和干预的潜在生物标志物。ObjectiveTo systematically evaluate the associations of C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)with post-stroke depression(PSD).MethodsPubMed,Embase,Cochrane Library,Web of Science,CNKI,and Wanfang databases were searched to collect literature comparing levels of CRP,IL-6,and TNF-αat the peripheral blood between PSD and non-PSD patients,with retrieval time limit from inception to June 2024.Literature was screened according to inclusion and exclusion criteria,and data were extracted.Newcastle-Ottawa Scale(NOS)was used to assess the quality of included literature.Meta analysis was conducted using Stata 18.0 software,and publication bias was assessed.ResultsA total of 21 pieces of literature with 3,177 participants were collected,including 1,425 patients with PSD and 1,752 patients with non-PSD.Meta analysis results showed that CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients(standardized mean difference[SMD]=0.930,95%CI:0.580-1.280,P<0.001).Subgroup analysis results showed that,among the 7 pieces of literature with CRP detection<14 days after stroke,CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients(SMD=0.640,95%CI:0.38-0.89,I 2=83.9%,P<0.001);among the 4 pieces of literature with CRP detection≧14 days after stroke,CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients(SMD=1.450,95%CI:0.820-2.090,P<0.001),enjoying higher heterogeneity(I 2=90.6%).IL-6 level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients(SMD=2.659,95%CI:1.583-3.735,P<0.001).No significant difference in TNF-αlevel at the peripheral blood was noted between PSD patients and non-PSD patients(SMD=0.403,95%CI:-0.208-1.014,P=0.196).ConclusionCRP and IL-6 levels at the peripheral blood in PSD patients are obviuosly higher than those in non-PSD patients,suggesting that CRP and IL-6 may be potential biomarkers f

关 键 词：脑卒中后抑郁 C反应蛋白 白细胞介素-6 肿瘤坏死因子-Α META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]