摘要
目的探讨血清脑源性神经营养因子(BDNF)水平对保守治疗的高血压脑出血(HICH)患者抑郁情绪发生的影响。方法回顾性连续纳入2014年4月至2017年12月唐山市工人医院首次以HICH住院的患者63例,男38例,女25例,出血量均≤30 ml。所有患者采用保守治疗,以酶联免疫吸附法检测血清BDNF水平,于入院时和出血后第21天采用美国国立卫生研究院卒中量表(NIHSS)评估瘫痪分级。于入院后第21天,采用Zung抑郁自评量表(SDS)进行抑郁情绪评定,将SDS评分≥53分患者纳入抑郁组,SDS评分<53分者纳入非抑郁组。对两组患者血清BDNF水平进行比较,采用二分类Logisitic回归分析方法分析保守治疗的HICH患者抑郁情绪发生的危险因素。结果 HICH抑郁组患者入院后第21天SDS评分为(54. 7±1. 5)分,明显高于非抑郁组[(44. 6±6. 5)分,t=7. 020,P <0. 01];抑郁组血清BDNF水平低于非抑郁组[(7. 0±1. 4)μg/L比(8. 6±1. 8)μg/L,t=-3. 433,P=0. 001],入院后第21天瘫痪分级抑郁组高于非抑郁组[(5. 4±1. 5)分比(3. 8±1. 1)分,t=4. 951,P <0. 01];抑郁组患者血清BDNF水平与SDS评分(r=-0. 535,P=0. 013)、出血量(r=-0. 578,P=0. 006)、第21天的瘫痪分级(r=-0. 715,P <0. 01)均呈负相关;二分类Logistic回归分析结果显示,高血清BDNF水平是保守治疗的HICH患者出现抑郁情绪的保护因素(OR=0. 990,95%CI:0. 983~0. 997,P=0. 008)。结论保守治疗的HICH患者出血后血清BDNF水平越低,越易出现抑郁情绪。
Objective To investigate the impact of serum brain-derived neurotrophic factor(BDNF) levels on depression of hypertensive cerebral hemorrhage(HICH) patients with conservative treatment. Methods From April 2014 to December 2017,a total of 63 patients with HICH hospitalized in the Department of Neurosurgery,Tangshan Gongren Hospital were enrolled.There were 38 males and 25 females patients.All had intracranial hematoma volume within 30 ml and received conservative treatment.Serum BDNF levels were detected using enzyme linked immunosorbent assay.The paralysis grade was assessed using National Institutes of Health Stroke Scale(NIHSS) on admission and the 21 st day after admission.The Zung Depression Self-rating Scale(SDS) was used to evaluate depression 21 days after admission.Patients with SDS score≥53 were divided into the depression group and with SDS score<53 were divided into the non-depression group.The differences of serum BDNF levels between the two groups were compared.Risk factors for depression of HICH patients with conservative treatment were analyzed by binary Logistic regression analysis. Results The SDS score of the depression group(54.7±1.5) on the 21st day after admission was significantly higher than that of the non-depression group(44.6± 6.5, t=7.020,P <0.01).The serum BDNF levels of the depression group was lower than that of the non-depression group(7.0±1.4 μg/L vs .8.6±1.8 μg/L, t=-3.433,P =0.001).The paralysis grade of the depression group was higher than that of the non-depression group on the 21st day after admission (5.4±1.5 vs .3.8±1.1, t=4.951,P <0.01).In the depression group,the serum BDNF level was negatively correlated with SDS score( r =-0.535, P =0.013),blood loss( r =-0.578 ,P = 0.006) and paralysis grade( r=-0.715,P <0.01) on the 21st day after admission.In binary Logistic regression analysis,serum BDNF level was a protective factor for depression in HICH patients undergoing conservative treatment( OR,0.990,95%CI 0.983 - 0.997, P =0.008). Conclusion The lower the serum BDN
作者
张晓飞
刘兴宇
崔建忠
田宝刚
王凯杰
洪军
王余
王海波
魏建强
魏玲
Zhang Xiaofei;Liu Xingyu;Cui Jianzhong;Tian Baogang;Wang Kaijie;Hong Jun;Wang Yu;Wang Haibo;Wei Jianqiang;Wei Ling(Department of Neurosurgery,Tangshan Gongren Hospital,Tangshan,Hebei 063000,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2019年第9期466-470,共5页
Chinese Journal of Cerebrovascular Diseases
基金
河北省科技计划项目(162777156)
关键词
颅内出血
高血压性
保守治疗
抑郁
脑源性神经营养因子
Intracranial hemorrhage,hypertensive
Conservative treatment
Depression
Brain-derived neurotrophic factor
