CAJ | 학술논문

目的探讨急性卒中患者血清中25羟基维生素D [25(OH)D]水平与卒中后抑郁的相关性. 方法对231例老年急性脑梗死后2～4周的患者进行抑郁的测量,采用的测量工具为精神疾病诊断与统计手册(DSM)-Ⅳ、贝克抑郁量表及伯恩斯抑郁量表.根据测量结果分为无抑郁组、抑郁症状组、轻度抑郁障碍组及重性抑郁组.采用受试者工作特征(ROC)曲线分析确定脑卒中重性抑郁患者的25(OH)D浓度的临界值. 结果入选患者血清25(OH)D浓度为(23.0±1.6)nmol/L,无抑郁组为(25.0±1.7) nmol/L,抑郁症状组为(23.7±1.6) nmol/L,轻度抑郁障碍组为(22.4±1.5)nmol/L,重性抑郁组为(16.3±1.5) nmol/L,重度抑郁组与轻度抑郁障碍组、抑郁症状和无抑郁组差异有统计学意义,轻度抑郁症组、抑郁症状组和无抑郁组间差异无统计学意义.皮尔森相关分析结果显示,贝克量表与伯恩斯量表的分数与25(OH)D水平呈负相关(r值分别为-0.24、-0.25,均P＜0.01);ROC分析提示脑卒中重性抑郁25(OH)D临界值为21.6 nmol/L. 结论血清25(OH)D浓度与脑卒后抑郁程度呈负相关.重性抑郁患者的血清25(OH)D浓度降低.
목적 탐토급성졸중환자혈청중25간기유생소D [25(OH)D]수평여졸중후억욱적상관성. 방법 대231례노년급성뇌경사후2～4주적환자진행억욱적측량,채용적측량공구위정신질병진단여통계수책(DSM)-Ⅳ、패극억욱량표급백은사억욱량표.근거측량결과분위무억욱조、억욱증상조、경도억욱장애조급중성억욱조.채용수시자공작특정(ROC)곡선분석학정뇌졸중중성억욱환자적25(OH)D농도적림계치. 결과 입선환자혈청25(OH)D농도위(23.0±1.6)nmol/L,무억욱조위(25.0±1.7) nmol/L,억욱증상조위(23.7±1.6) nmol/L,경도억욱장애조위(22.4±1.5)nmol/L,중성억욱조위(16.3±1.5) nmol/L,중도억욱조여경도억욱장애조、억욱증상화무억욱조차이유통계학의의,경도억욱증조、억욱증상조화무억욱조간차이무통계학의의.피이삼상관분석결과현시,패극량표여백은사량표적분수여25(OH)D수평정부상관(r치분별위-0.24、-0.25,균P＜0.01);ROC분석제시뇌졸중중성억욱25(OH)D림계치위21.6 nmol/L. 결론 혈청25(OH)D농도여뇌졸후억욱정도정부상관.중성억욱환자적혈청25(OH)D농도강저.
Objective To investigate the correlation between serum 25 hydroxyvitamin D[25 (OH) D] level and post-stroke depression in elderly patients with acute stroke.Methods Depression was assessed by Beck Depression Inventory (BDI),Burns Depression Checklist (BDC),and the Diagnostic and Statistical Manual of Mental Disorders Ⅳ in 231 elderly inpatients at 2-4 weeks after onset of acute cerebral infarction.According to the depression assessment,the patients were classified into four groups:normal group),depressive symptoms group,with mild depression group,and severe depression group.The cut-off point of 25 (OH) D level for post stroke depression was analyzed by receiver operating characteristic (ROC).Results The serum level of 25(OH)D was (23.0±1.6) nmol/L in all subjects,(25.0±1.7) nmol/L in normal group,(23.7± 1.6) nmol/L in depressive symptoms group,(22.4±1.5) nmol/L in mild depression group,(16.3± 1.5) nmol/L in severe depression group.Serum 25(OH) D level had significant differences between major depression groups and other three groups,while no significant differences were found between mild depression group,depressive symptoms group and normal group.Pearson correlation analysis showed that scores of BDI and BDC were inversely related to 25 (OH)D level (r=0.24 and-0.25,both P＜0.01).ROC curve analysis showed that the cut off point of serum 25 (OH) D level for severe post-stroke depression was 21.6 nmol/L.Conclusions Serum 25 (OH)D level is inversely related to depression.Serum 25(OH) D level is reduced in patients with severe post stroke depression.