血清脑源性神经营养因子水平与缺血性卒中后抑郁的相关性
International Journal of Cerebrovascular Diseases(2016)
Abstract
目的 探讨血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)与卒中后抑郁(post-stroke depression,PSD)的相关性.方法 前瞻性纳入90例缺血性卒中患者,入院后检测血清BDNF含量,采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评定神经功能缺损,采用Barthel指数(Barthel index,BI)评定日常生活活动能力.6个月随访时采用17项汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)进行抑郁评定,≥17分为抑郁,>24分为重度抑郁.结果 共40例患者(44.4%)发生PSD,轻度抑郁30例(33.3%),中度抑郁8例(8.9%),重度抑郁2例(2.2%).单变量分析显示,PSD组多发性梗死的患者比例(65.0%对32.0%;x2=9.723,P=0.002)、基线NIHSS评分[(7.05±4.25)分对(4.35±3.14)分;t=3.465,P =0.001]和出院时NIHSS评分[(5.43±3.02)分对(3.11±2.56)分;=3.944,P<0.001]显著高于非PSD组,而受教育年限[(9.03±4.51)年对(13.45 ±5.02)年;=4.340,P<0.001]、血清PDNF浓度[(16.754 ±4.451) pg/ml对(29.551 ±3.213)pg/ml;t =15.827,P<0.001]以及出院时BI[(55.00±28.10)分对(83.11±27.11)分;=4.809,P<0.001]显著低于非PSD组.多变量logistic回归分析显示,高血清BDNF水平是PSD的独立保护因素(优势比0.571,95%可信区间0.416 ~0.967;P=0.003).结论 高血清BDNF水平是PSD的独立保护因素.
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Key words
Stroke,Brain Ischemia,Depression,Brain-Derived Neurotrophic Factor,Risk Factors,Biomarkers
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