CAJ | 학술논문

目的：探讨缺血性脑卒中首次发作时血浆谷氨酸水平与脑卒中3月后抑郁发病的相关性。方法门诊收集80例首次患卒中且预后较好的患者，采用抑郁自评量表（ SDS）、健康状况调查问卷（ SF-36）以及17项汉密尔顿抑郁量表（ HDRs）评估患者抑郁症状严重程度以及健康状况。检测患者卒中后第2天以及卒中后第3个月血浆谷氨酸水平，分析卒中后3月抑郁症状与首次卒中发作时血浆中谷氨酸水平的相关性。结果卒中患者在卒中后第2天血浆谷氨酸水平与卒中后第3月HDRS（r＝－0．311）和SDS评分（r＝－0．476）呈显著负相关（均P＜0．05），而卒中后第2天血浆谷氨酸水平与卒中后第3月SF-36问卷得分呈显著正相关（r＝0．435，P＝0．021）；多因素logistic回归分析显示，卒中后第2天血浆谷氨酸水平与脑卒中后抑郁的发生独立相关（OR＝0．651，P＝0．022）。结论卒中后抑郁的发生可能与首次卒中患者血浆谷氨酸水平有关。
목적：탐토결혈성뇌졸중수차발작시혈장곡안산수평여뇌졸중3월후억욱발병적상관성。방법문진수집80례수차환졸중차예후교호적환자，채용억욱자평량표（ SDS）、건강상황조사문권（ SF-36）이급17항한밀이돈억욱량표（ HDRs）평고환자억욱증상엄중정도이급건강상황。검측환자졸중후제2천이급졸중후제3개월혈장곡안산수평，분석졸중후3월억욱증상여수차졸중발작시혈장중곡안산수평적상관성。결과졸중환자재졸중후제2천혈장곡안산수평여졸중후제3월HDRS（r＝－0．311）화SDS평분（r＝－0．476）정현저부상관（균P＜0．05），이졸중후제2천혈장곡안산수평여졸중후제3월SF-36문권득분정현저정상관（r＝0．435，P＝0．021）；다인소logistic회귀분석현시，졸중후제2천혈장곡안산수평여뇌졸중후억욱적발생독립상관（OR＝0．651，P＝0．022）。결론졸중후억욱적발생가능여수차졸중환자혈장곡안산수평유관。
Objective To find out the correlation of the level of plasma glutamate as observed in the first episode of ischemic stroke to the incidence of depression 3 months after the occurrence of the stroke.Method 80 cases of stroke with favorable prognosis were first chosen as the subjects of our study.The subjects were then surveyed with self-rating depression scale SDS),Health Survey (SF-36) and 17 Hamilton Depression Rating Scale (the 17-item Hamilton Depression Rating scale, HDRs) to obtain the data of the severity of depression and health status of the subjects.Next, the plasma level of glutamate on the next day right after the first incidence of stroke and those on the third months after the incidence of stroke were tested.The correlation of the plasma level of glutamate as observed in the first episode of ischemic stroke to the incidence of depression 3 months after the occurrence of the stroke were then analyzed.Findings The level of plasma glutamate as detected on the next day after the first incidence of stroke was found to have negative correlation with the HDRS and SDS scores as obtained on the third month after the incidence of stroke(r=-0.476,P=0.009,r=-0.311,P=0.013). However, it was found to have positive correlation with the SF-36 questionnaire score (r=0.435,P=0.021).Multivariate logistic regression analysis showed that the level of plasma glutamate on the next day right after the first incidence of stroke was independently correlated to PDS (OR=0.651,P =0.022).Conclusion Post-stroke depression may be positively correlated to the level of plasma glutamate in the first incidence of stroke.