Zhang Yu, He Ji-Rong, Liang Huai-Bin, Lu Wen-Jing, Yang Guo-Yuan, Liu Jian-Rong, Zeng Li-Li
Department of Neurology, Ruijin Hospital & Ruijin Hospital North, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Department of Neurology, Ruijin Hospital & Ruijin Hospital North, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
J Affect Disord. 2017 Oct 15;221:222-226. doi: 10.1016/j.jad.2017.06.045. Epub 2017 Jun 21.
To explore the associated factors of late-onset post-stroke depression (PSD).
A total of 251 patients with acute ischemic stroke were recruited. The evaluation of depression was performed 2 weeks after ischemia. 206 patients showing no depression in 2 weeks were followed up. They were divided into late-onset PSD group and non-depressed group by clinical interview with Hamilton depression scale score 3 months after stroke. On the first day following hospitalization, the clinical data including age, gender, educational level and vascular risk factors were recorded. The severity, etiological subtype and location of stroke were evaluated. The inflammatory mediators, glucose and lipid levels were recorded on the day of admission. The association between clinical factors and late-onset PSD was explored by logistic regression analysis. The ROC analysis was performed to evaluate the predicting power of the clinical factors.
187 of 206 patients completed the assessment 3 months after stroke. 19 (10.16%) patients were diagnosed as late onset PSD. Diabetes mellitus was an independent risk factor for late-onset PSD (OR 2.675, p = 0.047). ROC analysis demonstrated that glucose and HbA1C could predict late-onset PSD with specificity of 84.4%.
The sample of our study was small. The results should be further confirmed in a larger cohort of patients with acute ischemic stroke.
The acute ischemic stroke patients with diabetes mellitus were more tendered to suffer late-onset PSD.
探讨脑卒中后迟发性抑郁（PSD）的相关因素。
共纳入251例急性缺血性脑卒中患者。缺血2周后进行抑郁评估。对2周内无抑郁表现的206例患者进行随访。根据脑卒中后3个月采用汉密尔顿抑郁量表评分进行临床访谈，将其分为迟发性PSD组和非抑郁组。住院后第1天记录年龄、性别、教育程度及血管危险因素等临床资料。评估脑卒中的严重程度、病因亚型及部位。入院当天记录炎症介质、血糖和血脂水平。采用逻辑回归分析探讨临床因素与迟发性PSD的相关性。进行ROC分析以评估临床因素的预测能力。
206例患者中有187例在脑卒中后3个月完成评估。19例（10.16%）患者被诊断为迟发性PSD。糖尿病是迟发性PSD的独立危险因素（OR 2.675，p = 0.047）。ROC分析表明，血糖和糖化血红蛋白（HbA1C）可预测迟发性PSD，特异性为84.4%。
本研究样本量小。结果应在更大规模的急性缺血性脑卒中患者队列中进一步证实。
急性缺血性脑卒中合并糖尿病的患者更容易发生迟发性PSD。
