摘要
目的探讨血清白介素-6(IL-6)、神经丝轻链(NfL)蛋白、生长分化因子-15(GDF-15)联合检测对脑卒中后抑郁(PSD)的预测价值。方法选取2019年1月-2020年6月合肥市第一人民医院收治的149例急性缺血性脑卒中患者。取入院次日清晨空腹外周血,检测患者血清C反应蛋白(CRP)、IL-6、NfL、GDF-15等血清指标。随访3个月,根据是否诊断为PSD,将其分为PSD组(52例)和非PSD组(97例),采用多因素Logistic回归分析发生PSD的危险因素,绘制受试者工作特征曲线(ROC),确定血清指标对PSD的预测价值。结果PSD组患者血清CRP(8.54±1.51)ng/L、IL-6(11.53±1.94)ng/mL、NfL(129.92±12.81)pg/mL、GDF-15(1955.70±127.84)ng/L水平高于非PSD组患者CRP(4.64±0.71)ng/L、IL-6(7.26±1.16)ng/mL、NfL(39.31±5.94)pg/mL、GDF-15(1087.59±82.41)ng/L,差异有统计学意义(P<0.05)。血清IL-6、NfL、GDF-15水平是发生PSD的独立危险因素,IL-6、NfL、GDF-15联合检测的ROC曲线下面积(AUC)(0.962)、敏感性(86.74%)、特异性(96.91%)均高于单项指标及两两联合检测。结论血清IL-6、NfL、GDF-15水平是急性缺血性脑卒中患者是否发生PSD的独立危险因素,三项指标联合检测对PSD的诊断具有一定的临床价值。
Objective To investigate the predictive value of combined detection of serum interleukin-6(IL-6),neuroflament light(NfL)chain and growth differentiation factor-15(GDF-15)for post-stroke depression(PSD).Methods149 patients with acute ischemic stroke in our hospital were selected from January 2019 to June 2020.The fasting peripheral blood samples were collected on the next morning after admission,and the serum C-reactive protein(CRP),IL-6,NfL,GDF-15 and other serum indicators were detected.Patients were follow-up for three months.The patients were divided into PSD group(n=52)and non-PSD group(n=97)according to whether they were diagnosed as PSD or not.Multivariate Logistic regression analysis was used to identify the risk factors of PSD.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of serum parameters for PSD.Results The levels of serum CRP(8.54±1.51)ng/L,IL-6(11.53±1.94)ng/mL,NfL(129.92±12.81)pg/mL and GDF-15(1955.70±127.84)ng/L in PSD group were significantly higher than those in non-PSD group[CRP(4.64±0.71)ng/L,IL-6(7.26±1.16)ng/mL,NfL(39.31±5.94)pg/mL,GDF-15(1087.59±82.41)ng/L](P<0.05).The levels of serum IL-6,NfL and GDF-15 were independent risk factors for PSD.The area under curve(AUC)(0.962),sensitivity(86.74%)and specificity(96.91%)of combined detection of IL-6,NfL and GDF-15 were higher than those of single index and pairwise joint detection.Conclusion Serum levels of IL-6,NfL and GDF-15 were independent risk factors of PSD in patients with acute ischemic stroke,and the combined detection of these three indicators had certain clinical value in the diagnosis of PSD.
作者
彭松
刘婧
吴康
罗明晶
李瑞麟
PENG Song;LIU Jing;WU Kang;LUO Ming-jing;LI Rui-lin(Department of General Medicine,the Third Affiliated Hospital of Anhui Medical University,Western District,Hefei First Peoples Hospital,Hefei,Anhui 230061;Department of Pharmacy,the Third Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230061,China)
出处
《热带医学杂志》
CAS
2021年第8期992-995,1029,共5页
Journal of Tropical Medicine
基金
安徽省“十三五”医疗卫生重点专科建设项目(皖卫教科[2017]30号)
合肥市医学重点学科建设资助(合卫科教[2019]160号)
