论文部分内容阅读
目的:观察高原地区脑卒中后抑郁(PSD)的发生与患者睡眠质量和血清IL-6、TNF-α、hs-CRP水平关系。方法:收集世居海南州地区(海拔约3 000m)住院急性脑出血及动脉粥样硬化性脑梗死资料完整的汉族患者60例和同期健康汉族体检者30例作为观察对象,记录患者和体检者的有关临床资料,同时进行汉密尔顿抑郁量表(HDRS17)、睡眠质量(PSQI)评分,采用酶联免疫分析法、散射比浊法分别测定患者和体检者血清中IL-6、TNF-α和hs-CRP水平。根据DSM~IV抑郁症诊断标准,将患者分为抑郁组和非抑郁组,体检者为对照组,比较3组HDRS17、PSQI评分和血清中IL-6、TNF-α和hs-CRP水平。结果:急性期PSD发生率为26.7%,男女间PSD发生率比较有统计学差异(P<0.05)。3组HDRS17评分比较,PSD组>非PSD组,差异具有统计学意义(P<0.05),3组PSQI评分比较,PSD组>非PSD组>对照组,差异具有统计学意义(P<0.05),3组血清hs-CRP、IL-6水平比较,PSD组>非PSD组>对照组,差异具有统计学意义(P<0.05),3组血清TNF-α水平比较,PSD组>非PSD组,PSD组>对照组,差异具有统计学意义(P<0.05)。结论:高原地区卒中患者急性期PSD发生率较高,女性易患,睡眠质量和炎症反应影响PSD发生。
AIM: To observe the relationship between post-stroke depression (PSD) and sleep quality, serum IL-6, TNF-α and hs-CRP levels in high altitude areas. Methods: Sixty Han patients with complete data of hospitalized acute cerebral hemorrhage and atherosclerotic cerebral infarction living in Hainan Prefecture (about 3 000 m above sea level) and 30 healthy Han nationality subjects in the same period were enrolled in this study. The patients and the subjects were recorded The serum levels of IL-6, TNF-α and hs in serum of patients and subjects were determined by enzyme-linked immunosorbent assay (ELISA) and turbidimetry respectively. The data of HDRS17, PSQI, -CRP level. The patients were divided into depression group and non-depression group according to DSM-IV diagnostic criteria. The subjects were selected as the control group. HDRS17, PSQI score and serum levels of IL-6, TNF-α and hs-CRP in the three groups were compared. Results: The incidence of PSD in acute phase was 26.7%. The incidence of PSD between male and female was statistically significant (P <0.05). PSDRS> non-PSD group> PSD group> non-PSD group, the difference was statistically significant (P <0.05), PSQI score of 3 groups, PSD group> non-PSD group> (P <0.05). The level of serum TNF-α in three groups was significantly higher than that in PSD group> non-PSD group> control group , PSD group> control group, the difference was statistically significant (P <0.05). CONCLUSIONS: The incidence of PSD in the acute stage is higher in stroke patients in the plateau area. Female predisposition, sleep quality and inflammatory response affect PSD.