脑卒中后抑郁发病的影响因素

发布时间：2018-04-21 07:46

本文选题：卒中后抑郁 + 血清标志物　；参考：《山东医药》2017年09期

【摘要】：目的探讨卒中后抑郁发病的影响因素。方法选择65例脑卒中后抑郁患者(HAMD评分8~23分)为PSD组,其中中重度抑郁患者21例(中重度组),合并糖尿病患者26例(合并组)。选择同期住院脑卒中后无抑郁患者65例为对照组。住院期间及发病1个月后分别采用HAMD-17项进行评分;入选患者均进行一般资料及危险因素对比;住院2周内检测血清C反应蛋白(CRP)、胰岛素样生长因子1(IGF-1)及谷氨酸脱羧酶抗体(GAD-Ab)阳性率;分析两组患者病初NIHSS评分及病变部位。结果中重度组及合并组患者血清CRP和IGF-1水平升高明显,与对照组比较,P0.05;而PSD组血清CRP、IGF-1水平及GAD-Ab阳性率与对照组比较差异无统计学意义。PSD组额叶、丘脑病变、发病初高NIHSS评分及糖尿病所占比例高于对照组(P均0.05)。结论炎性反应、免疫机制异常及谷氨酸代谢障碍可能参与卒中后抑郁发病的病理过程,脑卒中后抑郁发病的影响因素有糖尿病、额叶病变、丘脑病变及病初高NIHSS评分。
[Abstract]:Objective to investigate the influencing factors of post-stroke depression. Methods 65 patients with post-stroke depression were selected as PSD group. 21 patients with moderate and severe depression and 26 patients with diabetes mellitus were selected as PSD group. Sixty-five inpatients without depression after stroke were selected as control group. HAMD-17 scores were used during hospitalization and 1 month after onset, general data and risk factors were compared among the selected patients. The positive rates of serum C-reactive protein (CRP), insulin-like growth factor (IGF-1) and glutamic acid decarboxylase antibody (GAD-Ab) were detected within 2 weeks of hospitalization, and the NIHSS score and lesion site of the two groups were analyzed. Results the serum levels of CRP and IGF-1 in moderate and severe group and combined group were significantly higher than those in control group (P 0.05), while the level of CRPnIGF-1 and the positive rate of GAD-Ab in PSD group were not significantly different from those in control group. The high NIHSS score and the proportion of diabetes mellitus were higher than those of the control group (P < 0.05). Conclusion inflammatory reaction, abnormal immune mechanism and impaired glutamate metabolism may be involved in the pathological process of post-stroke depression. The influencing factors of post-stroke depression are diabetes mellitus, frontal lobe disease, thalamic lesion and high NIHSS score.
【作者单位】：青岛大学附属医院;曹县人民医院;
【分类号】：R743.3;R749.4

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