摘要
目的探讨血清皮质醇、中性粒细胞与淋巴细胞比值(NLR)、胰岛素样生长因子-1(IGF-1)及白细胞介素-6(IL-6)在脑卒中后抑郁中的表达及临床价值。方法收集175例脑卒中患者进行研究,根据3个月抑郁发生情况,将患者分为抑郁组(74例)和非抑郁组(101例),比较两组患者血清皮质醇、NLR、IGF-1及IL-6水平及其对脑卒中后抑郁的评估价值,并分析导致脑卒中发生抑郁的独立危险因素。结果抑郁组患者血清皮质醇、NLR、IGF-1及IL-6水平高于非抑郁组(P<0.05)。ROC曲线分析显示,皮质醇、NLR、IGF-1、IL-6对脑卒中后抑郁的预测价值的AUC分别为0.883、0.776、0.876、0.865,采用Z检验比较AUC差异,皮质醇、IGF-1的AUC高于NLR(P<0.05)。根据最佳临界值,当皮质醇高于99.46 ng/ml时,其敏感度为64.9%,特异度为99.0%;当NLR高于3.84时,其敏感度为50.0%,特异度为98.0%;当IGF-1高于31.08 ng/ml时,其敏感度为77.0%,特异度为91.1%;当IL-6高于68.17 ng/L时,其敏感度为70.3%,特异度为85.1%。多因素Logistic回归分析显示,负性生活事件、高斯堪的纳维亚卒中量表(SSS)评分、高水平皮质醇、高水平IGF-1、高水平IL-6是脑卒中后发生抑郁的独立危险因素(P<0.05)。结论血清皮质醇、NLR、IGF-1及IL-6在脑卒中后抑郁中呈高表达,对脑卒中后抑郁的发生有一定预测价值,并且血清皮质醇、IGF-1、IL-6是脑卒中后抑郁发生的独立危险因素。
Objective To explore the expression and clinical value of serum cortisol,neutrophil to lymphocyte ratio(NLR),insulin-like growth factor-1(IGF-1)and interleukin-6(IL-6)in post-stroke depression.Methods A total of 175 stroke patients were selected and divided into depression group(74 cases)and non-depression group(101 cases)according to the occurrence of depression in 3 months.Levels of serum cortisol,NLR,IGF-1 and IL-6 in two groups were compared,and their evaluation values for post-stroke depression were analyzed,to analyze independent risk factors for depression after stroke.Results The levels of serum cortisol,NLR,IGF-1 and IL-6 in depression group were all significantly higher than those in non-depression group(P<0.05).ROC curve analysis showed that the AUCs of cortisol,NLR,IGF-1,and IL-6 for the predictive value of post-stroke depression were 0.883,0.776,0.876,0.865,respectively.The Z test was used to compare the differences in AUCs,and the AUCs of cortisol,IGF-1 were higher than that of NLR(P<0.05).According to the best cut-off value,when cortisol level was higher than 99.46 ng/ml,its sensitivity was 64.9%and specificity was 99.0%;when NLR was higher than 3.84,its sensitivity was 50.0%and specificity was 98.0%;when IGF-1 level was higher than 31.08 ng/ml,its sensitivity was 77.0%and specificity was 91.1%;when IL-6 level was higher than 68.17 ng/L,its sensitivity was 70.3%and specificity was 85.1%.Multivariate logistic regression showed that negative life events,high score of Scandinavian Stroke Scale(SSS),high levels of cortisol,IGF-1,and IL-6 were independent risk factors for depression after stroke(P<0.05).Conclusion Serum cortisol,NLR,IGF-1 and IL-6 are highly expressed in patients with post-stroke depression,which has a certain predictive value for the occurrence of post-stroke depression,and serum cortisol,IGF-1 and IL-6 are independent risk factors for depression after stroke.
作者
孙李晴
江依勇
蔡溢
蔡艳
邵田莉
SUN Liqing;JIANG Yiyong;CAI Yi(Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518000, China)
出处
《精神医学杂志》
2021年第4期308-311,共4页
Journal of Psychiatry
基金
广东省高水平临床重点专科(编号:SZGSP013)
湖南省自然科学基金(编号:2019JJ50309)。
