血清白细胞介素-18是中风后抑郁症发生的一个潜在标志物。
The serum interleukin-18 is a potential marker for development of post-stroke depression.
作者信息
Yang Lingli, Zhang Zhijun, Sun Dingming, Xu Zhi, Zhang Xiangrong, Li Lingjiang
机构信息
Medical College, Southeast University, Nanjing, China.
出版信息
Neurol Res. 2010 May;32(4):340-6. doi: 10.1179/016164110X12656393665080.
OBJECTIVE
Depression is a common mood disorder affecting stroke patients. It is associated with poorer outcome and increased mortality in stroke patients. The aim of this work was to test whether serum levels of proinflammatory cytokines are correlated with the development of depression after stroke.
METHODS
One hundred ischemic stroke patients admitted to the hospital within the first 24 hours after stroke onset were consecutively recruited and followed up for 6 months. The 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were used to screen for depressive symptoms on days 3, 7 and 14 after admission and at 6 months after stroke onset. Based on the symptoms elicited from these two scales, diagnoses of depression were made in accordance with DSM-IV criteria for post-stroke depression. Serum levels of proinflammatory cytokines (IL-6, IL-18 and TNF-alpha) of all the patients were determined by ELISA on both days 1 and 7 after admission. Meanwhile, 50 healthy control subjects were also recruited; they underwent measurement of serum levels of proinflammatory cytokines once.
RESULTS
Thirty-seven patients (37.0%) were diagnosed as having major depression at 2 weeks. Serum IL-18 on both days 1 and 7 was significantly higher in both post-stroke depression patients and non-post-stroke depression patients than in normal controls. Serum IL-18 on day 7 was significantly higher in post-stroke depression patients than in non-post-stroke depression patients. Serum IL-18 >377.84 pg/ml on day 7 was independently associated with incident post-stroke depression at the acute stage of stroke (odds ratio: 12.280, 95% confidence interval: 3.848-39.190, p<0.001 after adjustment). At 6 months, 31 patients (33.0%) were diagnosed with major depression. Serum IL-18 >376.67 pg/ml on day 7 was independently associated with post-stroke depression at 6 months (odds ratio: 7.431, 95% confidence interval: 1.741-31.712, p=0.007 after adjustment).
CONCLUSIONS
Serum IL-18 on day 7 after admission may predict the risk of post-stroke depression both at the acute stage of stroke and at 6 months post-stroke.
目的
抑郁症是一种影响中风患者的常见情绪障碍。它与中风患者较差的预后和死亡率增加有关。本研究的目的是测试促炎细胞因子的血清水平是否与中风后抑郁症的发生相关。
方法
连续招募100例在中风发作后24小时内入院的缺血性中风患者，并随访6个月。采用17项汉密尔顿抑郁量表（HDRS）和蒙哥马利-艾斯伯格抑郁量表（MADRS）在入院后第3、7和14天以及中风发作后6个月筛查抑郁症状。根据这两个量表引出的症状，按照DSM-IV标准对中风后抑郁症进行诊断。所有患者在入院第1天和第7天通过酶联免疫吸附测定法（ELISA）测定促炎细胞因子（IL-6、IL-18和TNF-α）的血清水平。同时，还招募了50名健康对照者；他们仅进行一次促炎细胞因子血清水平的测定。
结果
37例患者（37.0%）在2周时被诊断为重度抑郁症。中风后抑郁症患者和非中风后抑郁症患者在第1天和第7天的血清IL-18均显著高于正常对照组。中风后抑郁症患者在第7天的血清IL-18显著高于非中风后抑郁症患者。第7天血清IL-18>377.84 pg/ml与中风急性期发生中风后抑郁症独立相关（比值比：12.280，95%置信区间：3.848 - 39.190，调整后p<0.001）。在6个月时，31例患者（33.0%）被诊断为重度抑郁症。第7天血清IL-18>376.67 pg/ml与6个月时的中风后抑郁症独立相关（比值比：7.431，95%置信区间：1.741 - 31.712，调整后p = 0.007）。
结论
入院后第7天的血清IL-18可能预测中风急性期和中风后6个月时中风后抑郁症的风险。
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