摘要
目的探究血清Th细胞因子在脑卒中后抑郁患者血清中的表达水平。方法前瞻性选取2016年9月至2018年9月海南省安宁医院收治的100例在脑卒中发病后24 h内入院的缺血性脑卒中抑郁患者(脑卒中后抑郁组,n=37)、脑卒中后非抑郁患者(脑卒中后非抑郁组n=63)和同期体检健康的受试者(正常对照组,n=50)。利用酶联免疫吸附试验检测三组入院后第1、7天的血清Th细胞因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白细胞介素-18(IL-18)的表达水平,采用Logistic回归分析法分析脑卒中后抑郁的相关因素。结果 100例脑卒中患者中有37例(37. 0%)在入院2周时被诊断为重度抑郁症。入院后第1天,脑卒中患者血清IL-6、TNF-α和IL-18表达水平(7. 99±3. 36 pg/ml;12. 97±5. 30 pg/ml;370. 38±127. 09 pg/ml)明显高于正常对照组(5. 02±2. 06 pg/ml;9. 69±3. 99 pg/ml;168. 96±75. 26 pg/ml)(P <0. 05)。入院后第7天,脑卒中患者血清IL-6、TNF-α和IL-18水平仍明显高于正常对照组(P <0. 05),脑卒中后抑郁组患者血清IL-18表达水平(463. 47±134. 83 pg/ml)明显高于脑卒中后非抑郁组患者(343. 62±119. 14 pg/ml,P <0. 05),而脑卒中后抑郁组与脑卒中后非抑郁组患者血清IL-6(7. 03±3. 10pg/ml vs. 8. 16±3. 80 pg/ml)、TNF-α(11. 74±4. 36 pg/ml vs. 10. 67±4. 27 pg/ml)水平无显著差异(P <0. 05)。脑卒中后第7天血清IL-1是脑卒中急性期并发抑郁症的独立危险因素(OR=1. 008,95%CI:1. 004~1. 011,P <0. 01),而血清IL-6、TNF-α水平与脑卒中后抑郁症的发生无相关性,分别为OR=1. 069,95%CI:0. 417~2. 471,P> 0. 05和OR=1. 081,95%CI:0. 562~2. 011,P> 0. 00。结论脑卒中后第7天血清Th细胞因子IL-18表达显著增高,且与脑卒中后并发抑郁症具有相关性。
Objective To explore the expression level of serum Th cytokine in patients with post-stroke depression. Methods 100 patients with ischemic stroke during September 2016 to September 2018 were listed in the poststroke depression group( n = 37) and 63 patients without depression were listed in the post-stroke non-depression group( n = 63)),they admitted to the hospital within 24 hours after the onset of stroke,and 50 healthy controls were listed as control group. The levels of serum Th cytokine,interleukin 6,( IL-6),Tumor Necrosis Factor α( TNF-α) and interleukin 18( IL-18) were measured by enzyme-linked immunosorbent assay( ELISA) on the 1 st and 7 th day after admission. Results Of these 100 stroke patients,37( 37. 0%) were diagnosed as major depression in 2 weeks of admission. On the first day after admission,serum levels of IL-6,TNF-α and IL-18 in stroke patients were 7. 99 ± 3. 36 pg/ml;12. 97 ± 5. 30 pg/ml;370. 38 ± 127. 09 pg/ml respectively,they were significantly higher than those of control group( 5. 02 ± 2. 06 pg/ml;9. 69 ± 3. 99 pg/ml;168. 96 ± 75. 26 pg/ml)( P <0. 05). In 7 days after admission,in cerebral apoplexy patients,their serum levels of IL-6,TNF-α and IL-18 were significantly higher than those of control group( P < 0. 05) and depression after stroke patients,serum IL-18 expression level( 463. 47 ± 134. 83 pg/ml) in patients with depression after stroke were significantly higher than those of patients in depression group after stroke( 343. 62 ± 119. 14 pg/ml,P < 0. 05),while patients in depression after stroke group and the serum levels of IL-6 and TNF-α were not significantly different( P < 0. 05). Serum level of IL-1 on 7 th day after stroke was an independent risk factor for patients with acute stroke and depression( OR = 1. 008,95% CI: 1. 004-1. 011,P < 0. 01),while serum levels of IL-6 and TNF-α were not correlated with the occurrence of post-stroke depression( OR = 1. 069,95% CI:0. 417-2. 471,P > 0. 05 and OR = 1. 081,95% CI: 0. 562 ~ 2. 011,P > 0. 00). Conclusion The express
作者
吴红霞
韩天明
欧小凡
吴传东
凌卫仙
刘向来
WU Hong-xia;HAN Tian-ming;OU Xiao-fan(Department of Neurology,Hainan Anning Hospital,Haikou Hainan 570105,China.)
出处
《临床和实验医学杂志》
2019年第17期1841-1844,共4页
Journal of Clinical and Experimental Medicine
基金
海南省自然科学基金面上项目(编号:817371)
