Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325000, China.
Neurol Sci. 2018 Jun;39(6):999-1007. doi: 10.1007/s10072-018-3287-4. Epub 2018 Mar 6.
Post-stroke anxiety (PSA) is a common neuropsychiatric affective disorder occurring after stroke. The purpose of this study was to investigate the association between anxiety and the serum levels of oxidative stress markers at admission. First-ever or recurrent ischemic stroke patients were consecutively recruited into the study and followed up 1 month. Patients were divided into PSA and non-PSA group according DSM-IV criteria for anxiety due to stroke. Overall, 49 patients (24.1%) were diagnosed anxiety. Serum GPX (glutathione peroxidase), CAT (catalase), SOD (superoxide dismutase), and MDA (malondialdehyde) were significantly higher in patients with anxiety than patients without anxiety. The HAM-A scores had a significant positive association with MDA levels. In multivariate logistic regression analysis, serum antioxidant enzymes and MDA were independent predictors of PSA. An increased risk of PSA was associated with serum MDA levels ≥ 3.0 nmol/ml (adjusted OR 8.68, 95% CI 3.02-24.95; P < 0.001) after adjusting for relevant confounders such as social support and treatments at admission. Elevated serum levels of lipid oxidation products and antioxidant enzymes at admission were associated with anxiety 1 month after stroke, suggesting that these alterations might participate in the pathophysiology of anxiety symptoms in stroke patients.
卒中后焦虑（PSA）是一种常见的发生于卒中后的神经精神情感障碍。本研究旨在探讨入院时氧化应激标志物的血清水平与焦虑之间的关系。首次或复发性缺血性卒中患者连续入组并随访 1 个月。根据 DSM-IV 卒中后焦虑标准，患者被分为 PSA 和非 PSA 组。共有 49 名患者（24.1%）被诊断为焦虑。与无焦虑的患者相比，焦虑患者的血清 GPX（谷胱甘肽过氧化物酶）、CAT（过氧化氢酶）、SOD（超氧化物歧化酶）和 MDA（丙二醛）水平显著升高。HAM-A 评分与 MDA 水平呈显著正相关。在多变量 logistic 回归分析中，血清抗氧化酶和 MDA 是 PSA 的独立预测因子。在校正了入院时的社会支持和治疗等相关混杂因素后，血清 MDA 水平≥3.0nmol/ml 与 PSA 风险增加相关（调整后的 OR 8.68，95%CI 3.02-24.95；P<0.001）。卒中后 1 个月，血清脂质氧化产物和抗氧化酶水平升高与焦虑相关，提示这些改变可能参与了卒中患者焦虑症状的病理生理过程。
