中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2013年
6期
367-370
,共4页
脑血管意外%抑郁%谷氨酸
腦血管意外%抑鬱%穀氨痠
뇌혈관의외%억욱%곡안산
Cerebrovascular accident%Depression%Glutamic acid
目的 初步探讨急性缺血性卒中患者血浆谷氨酸水平与卒中后抑郁(post-strokedepression,PSD)的关系.方法 于卒中后2周,采用Beck抑郁问卷(21项)及《美国精神障碍诊断与统计手册(第4版)》躯体疾病所致心境障碍诊断标准,对连续入组的74例急性缺血性卒中患者进行PSD诊断,以17项汉密尔顿抑郁量表(the 17-item Hamilton Depression Rating Scale,HDRS)评估抑郁症状严重程度,并采用高效液相色谱技术比较PSD患者和非PSD患者卒中后第2天及卒中后第2周的血浆谷氨酸水平.结果 (1) PSD患者卒中后第2天血浆谷氨酸水平显著低于非PSD患者[(4.995 ±2.514) g/L对(6.558 ±2.835) g/L;t=2.140,P=0.036];(2)卒中患者在卒中后第2天血浆谷氨酸水平与卒中后第2周HDRS评分呈显著负相关(r=-0.311,P=0.013);(3)PSD患者卒中后第2周血浆谷氨酸水平[(6.312 ±2.604) g/L]较卒中后第2天显著升高(t=-2.361,P=0.026);(4)多因素logistic回归分析显示,卒中后第2天血浆谷氨酸水平与PSD的发生独立相关(OR =0.651,95％可信区间为0.459 ～0.922,P=0.016).结论 PSD的发生可能与血浆谷氨酸水平有关.
目的 初步探討急性缺血性卒中患者血漿穀氨痠水平與卒中後抑鬱(post-strokedepression,PSD)的關繫.方法 于卒中後2週,採用Beck抑鬱問捲(21項)及《美國精神障礙診斷與統計手冊(第4版)》軀體疾病所緻心境障礙診斷標準,對連續入組的74例急性缺血性卒中患者進行PSD診斷,以17項漢密爾頓抑鬱量錶(the 17-item Hamilton Depression Rating Scale,HDRS)評估抑鬱癥狀嚴重程度,併採用高效液相色譜技術比較PSD患者和非PSD患者卒中後第2天及卒中後第2週的血漿穀氨痠水平.結果 (1) PSD患者卒中後第2天血漿穀氨痠水平顯著低于非PSD患者[(4.995 ±2.514) g/L對(6.558 ±2.835) g/L;t=2.140,P=0.036];(2)卒中患者在卒中後第2天血漿穀氨痠水平與卒中後第2週HDRS評分呈顯著負相關(r=-0.311,P=0.013);(3)PSD患者卒中後第2週血漿穀氨痠水平[(6.312 ±2.604) g/L]較卒中後第2天顯著升高(t=-2.361,P=0.026);(4)多因素logistic迴歸分析顯示,卒中後第2天血漿穀氨痠水平與PSD的髮生獨立相關(OR =0.651,95％可信區間為0.459 ～0.922,P=0.016).結論 PSD的髮生可能與血漿穀氨痠水平有關.
목적 초보탐토급성결혈성졸중환자혈장곡안산수평여졸중후억욱(post-strokedepression,PSD)적관계.방법 우졸중후2주,채용Beck억욱문권(21항)급《미국정신장애진단여통계수책(제4판)》구체질병소치심경장애진단표준,대련속입조적74례급성결혈성졸중환자진행PSD진단,이17항한밀이돈억욱량표(the 17-item Hamilton Depression Rating Scale,HDRS)평고억욱증상엄중정도,병채용고효액상색보기술비교PSD환자화비PSD환자졸중후제2천급졸중후제2주적혈장곡안산수평.결과 (1) PSD환자졸중후제2천혈장곡안산수평현저저우비PSD환자[(4.995 ±2.514) g/L대(6.558 ±2.835) g/L;t=2.140,P=0.036];(2)졸중환자재졸중후제2천혈장곡안산수평여졸중후제2주HDRS평분정현저부상관(r=-0.311,P=0.013);(3)PSD환자졸중후제2주혈장곡안산수평[(6.312 ±2.604) g/L]교졸중후제2천현저승고(t=-2.361,P=0.026);(4)다인소logistic회귀분석현시,졸중후제2천혈장곡안산수평여PSD적발생독립상관(OR =0.651,95％가신구간위0.459 ～0.922,P=0.016).결론 PSD적발생가능여혈장곡안산수평유관.
Objective To test the association between the plasma glutamate levels during acute ischemic stroke and post-stroke depression (PSD) initially.Methods Seventy-four ischemic stroke patients admitted to the hospital within the first day of stroke onset were evaluated at a follow-up of 2 weeks.The Beck Depression Inventory (BDI,21-item) and DSM-Ⅳ criteria was used to diagnose post-stroke depression (PSD) at 2 weeks after stroke.The Hamilton Depression Rating Scale (HDRS,17-item) was used to assess the severity of major depressive symptoms.Plasma level of glutamate between PSD and non-PSD patients was measured by high performance liquid chromatography (HPLC) on day 2 and 2 weeks after stroke.Results (1) The glutamate levels on day 2 after stroke were significantly lower in PSD patients(Twenty-six patients) than non-PSD patients [(4.995 ±2.514) g/L vs.(6.558 ±2.835) g/L;t =2.140,P =0.036].(2) In post-stroke patients,a strong negative correlation was observed between glutamate levels on day 2 after stroke and severity of depression(r =-0.311,P =0.013).(3) In patients with PSD,the levels of glutamate at 2 weeks after stroke (6.312 ± 2.604) g/L significantly increased compared to the levels of glutamate on day 2 after stroke (t =-2.361,P =0.026).(4) Using a multivariate logistic regression,plasma glutamate on day 2 was associated with incident PSD at 2 weeks after stroke (OR =0.651,95％ CI:0.459-0.922,P =0.016).Conclusion Plasma glutamate during the acute phase of stroke may be associated with PSD.
