School of Psychological Science, La Trobe University, Bundoora, Victoria, Australia.
Clin Interv Aging. 2013;8:69-74. doi: 10.2147/CIA.S38547. Epub 2013 Jan 22.
Depression is common in elderly stroke survivors and has been associated with systemic inflammation. We aimed to investigate an elderly population of Swedish stroke patients for evidence of sustained peripheral inflammation 18 months post-stroke and to identify if inflammation is associated with post-stroke depression at 18 months post-stroke.
The Barthel Index was used to measure the level of impairment in activities of daily living at 3 days post-stroke. Serum concentrations of inflammation markers, ie, C-reactive protein and white cell count, were measured in 149 stroke patients (mean age 81 ± 5.33 years, 35% male) at 18 months post-stroke, and a comparison was made with an age-matched sample of elderly Swedish individuals who had not suffered a stroke. At the same visit, clinical depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised criteria. Severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS).
Mean C-reactive protein and white cell count levels in stroke patients were significantly elevated at 18 months post-stroke compared with population probands. Disability scores were associated with MADRS depression scores, but C-reactive protein and white cell count were not.
We found evidence for a sustained peripheral inflammatory response at 18 months post-stroke. C-reactive protein and white cell count were not associated with depression in this study.
抑郁在老年卒中幸存者中很常见,并且与全身炎症有关。我们旨在调查瑞典老年卒中患者人群,以发现卒中后 18 个月是否存在持续的外周炎症,并确定炎症是否与卒中后抑郁相关。
采用 Barthel 指数评估卒中后 3 天患者日常生活活动的受损程度。在卒中后 18 个月,对 149 名卒中患者(平均年龄 81 ± 5.33 岁,35%为男性)的炎症标志物血清浓度(即 C 反应蛋白和白细胞计数)进行测量,并与未发生卒中的年龄匹配的瑞典老年人样本进行比较。在同一时间,根据《精神障碍诊断与统计手册》第三版修订版标准诊断临床抑郁症。使用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估抑郁严重程度。
卒中患者的 C 反应蛋白和白细胞计数水平在卒中后 18 个月显著升高,与普通人群相比。残疾评分与 MADRS 抑郁评分相关,但 C 反应蛋白和白细胞计数与抑郁评分不相关。
我们发现卒中后 18 个月存在持续的外周炎症反应。在本研究中,C 反应蛋白和白细胞计数与抑郁无关。