脑梗死后抑郁与血清谷氨酸水平相关性分析(1)
【摘要】 目的：探究观察脑梗死后抑郁(poststroke depression，PSD)与血清谷氨酸水平的关系。方法：选取2016年3月-2017年2月在本院神经内科住院的急性脑梗死患者82例，首次发病1周内采用DSM-5心境障碍诊断标准对入组患者进行抑郁诊断，将其分为抑郁组39例和正常组43例。采用汉密尔顿抑郁量表(hamilton depression rating scale，HDRS)评估抑郁程度，美国国立卫生研究院卒中量表(national institute of health stroke scale，NIHSS)评估神经功能缺损程度，测定两组的血清谷氨酸水平。结果：抑郁组发病周NIHSS评分显著高于正常组(P<0.001)；抑郁组第1周、1个月的血清谷氨酸水平均显著低于正常组(P<0.001)；抑郁组第1周、1个月的HDRS评分均显著高于正常组(P<0.001)；Spearman相关性分析可见，第1周、1个月血清谷氨酸水平与NIHSS、HDRS评分均呈显著的负相关(P<0.05)。结论：脑梗死后出现的血清谷氨酸水平升高，与神经功能损伤程度相关，也与PSD密切相关。
【关键词】 脑梗死； 抑郁； 血清谷氨酸水平
【Abstract】 Objective：To explore the relationship between poststroke depression(PSD) and serum glutamate levels.Method：82 patients with acute cerebral infarction admitted to our hospital from March 2016 to February 2017 were selected，the first attack occurred within 1 week，depression was diagnosed by DSM-5 diagnostic criteria for mood disorders，they were divided into 39 cases of depression after cerebral infarction group and 43 cases of normal group.The Hamilton Depression Scale(HDRS) was used to assess the severity of depression，and the National Institutes of Health Stroke Scale(NIHSS) was used to assess the extent of neurological deficits，Serum glutamate levels were measured of two groups.Result：The score of NIHSS scale of depression group within 1 week of onset was significantly higher than that of normal group(P<0.001)；the serum glutamic levels in depression group at first week and 1 month were significantly lower than those of normal group(P<0.001)，the HDRS scores in depression group at first weeks and 1 month were significantly higher than those of normal group(P<0.001)；Spearman correlation analysis shouwed that，at first week and 1 month，the serum glutamic levels were significantly negatively correlated with NIHSS score and HDRS score(P<0.05).Conclusion：The level of serum glutamic increased in cerebral infarction，which was related to the degree of nerve function damage，and also closely related to PSD.
【Key words】 Cerebral infarction； Depression； Serum glutamate levels
First-author’s address：Enping People’s Hospital，Enping 529400，China
doi：10.3969/j.issn.1674-4985.2017.33.036
腦梗死是具有高发病率、高死亡率、高残疾率等特征的中老年人常见病，是国内仅次于肿瘤的死亡原因，也是老年人致残的首要原因，是全球首要的健康问题[1]。脑梗死患者极易并发精神障碍，其中以抑郁障碍是最为常见，既往研究表明脑梗死后抑郁(poststroke depression，PSD)发生率为20%～79%[2]。严重影响脑梗死后的功能康复，同时也严重影响康复训练的效果[3]。谷氨酸为中枢神经系统重要的兴奋性神经递质，但当其在各种因素作用下异常升高时，对中枢神经系统则具有兴奋性神经毒性作用[4]，但在病理状态下，过度激活谷氨酸具有很强的神经兴奋性毒性，可致神经细胞的损害[5]。目前国内外少有文献探讨PSD与血清谷氨酸水平关系，及探讨谷氨酸在PSD的意义。本研究选取2016年3月-2017年2月本院脑梗死患者82例，探究PSD与血清谷氨酸水平的关系，现报道如下。, 百拇医药(何苑英 冯文志 莫雪梅 岑坚兴 陈汉文 陈秀园)
【关键词】 脑梗死； 抑郁； 血清谷氨酸水平
【Abstract】 Objective：To explore the relationship between poststroke depression(PSD) and serum glutamate levels.Method：82 patients with acute cerebral infarction admitted to our hospital from March 2016 to February 2017 were selected，the first attack occurred within 1 week，depression was diagnosed by DSM-5 diagnostic criteria for mood disorders，they were divided into 39 cases of depression after cerebral infarction group and 43 cases of normal group.The Hamilton Depression Scale(HDRS) was used to assess the severity of depression，and the National Institutes of Health Stroke Scale(NIHSS) was used to assess the extent of neurological deficits，Serum glutamate levels were measured of two groups.Result：The score of NIHSS scale of depression group within 1 week of onset was significantly higher than that of normal group(P<0.001)；the serum glutamic levels in depression group at first week and 1 month were significantly lower than those of normal group(P<0.001)，the HDRS scores in depression group at first weeks and 1 month were significantly higher than those of normal group(P<0.001)；Spearman correlation analysis shouwed that，at first week and 1 month，the serum glutamic levels were significantly negatively correlated with NIHSS score and HDRS score(P<0.05).Conclusion：The level of serum glutamic increased in cerebral infarction，which was related to the degree of nerve function damage，and also closely related to PSD.
【Key words】 Cerebral infarction； Depression； Serum glutamate levels
First-author’s address：Enping People’s Hospital，Enping 529400，China
doi：10.3969/j.issn.1674-4985.2017.33.036
腦梗死是具有高发病率、高死亡率、高残疾率等特征的中老年人常见病，是国内仅次于肿瘤的死亡原因，也是老年人致残的首要原因，是全球首要的健康问题[1]。脑梗死患者极易并发精神障碍，其中以抑郁障碍是最为常见，既往研究表明脑梗死后抑郁(poststroke depression，PSD)发生率为20%～79%[2]。严重影响脑梗死后的功能康复，同时也严重影响康复训练的效果[3]。谷氨酸为中枢神经系统重要的兴奋性神经递质，但当其在各种因素作用下异常升高时，对中枢神经系统则具有兴奋性神经毒性作用[4]，但在病理状态下，过度激活谷氨酸具有很强的神经兴奋性毒性，可致神经细胞的损害[5]。目前国内外少有文献探讨PSD与血清谷氨酸水平关系，及探讨谷氨酸在PSD的意义。本研究选取2016年3月-2017年2月本院脑梗死患者82例，探究PSD与血清谷氨酸水平的关系，现报道如下。, 百拇医药(何苑英 冯文志 莫雪梅 岑坚兴 陈汉文 陈秀园)