Chen Liping, Xiong Siqing, Liu Yi, Lin Meiqing, Wang Jirui, Zhong Renjia, Zhao Jiuhan, Liu Wenjing, Zhu Lu, Shang Xiuli
Department of Neurology, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, China; Department of Neurology, The Ji'an Central People's Hospital, Ji'an City, Jiangxi Province, China.
Department of Urinary Surgery, The Ji'an Central People's Hospital, Ji'an City, Jiangxi Province, China.
J Stroke Cerebrovasc Dis. 2018 Jul;27(7):1861-1869. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.021. Epub 2018 Mar 13.
Apathy is a multidimensional syndrome referring to a primary lack of motivation that occurs frequently in survivors of stroke. Higher C-reactive protein (CRP) level was associated with higher apathy scores among Alzheimer disease cases. However, data on the relationship between CRP levels and apathy in patients with stroke are lacking. So, we hypothesized an association between CRP and poststroke apathy (PSA).
Two hundred ninety-two consecutive patients with stroke were recruited within 7 days after stroke. Apathy symptoms were assessed at baseline and at 1, 3, and 6 months after stoke using the Apathy Evaluation Scale-Clinical (AES-C). Demographic and clinical information were obtained using the National Institutes of Health Stroke Scale (NIHSS) scores, Barthel Index (BI) scores, Mini-Mental State Examination (MMSE) scores, Hamilton Depression Scale (HAMD) scores, and Hamilton Anxiety Scale (HAMA) scores. CRP was measured at baseline. The presence and the location of infarcts were evaluated using magnetic resonance imaging.
Apathy at baseline was significantly associated with body mass index (BMI), NIHSS, BI, MMSE, HAMD, and CRP (P < .05) upon admission. PSA at 6 months was significantly associated with elevated CRP concentrations, high AES-C score, and low BI score (P < .05) upon admission. The AES-C scores peaked 3 months after stroke, but then abated over 6 months.
CRP, BMI, MMSE, depression, and disability are closely related to apathy during the acute stage of ischemic stroke. Lower BI scores, higher CRP concentrations, and apathy in acute stroke phase increased the risk of PSA at 6 months.
淡漠是一种多维度综合征，指的是动机原发性缺乏，在中风幸存者中经常出现。在阿尔茨海默病患者中，较高的C反应蛋白（CRP）水平与较高的淡漠评分相关。然而，关于中风患者CRP水平与淡漠之间关系的数据尚缺乏。因此，我们推测CRP与中风后淡漠（PSA）之间存在关联。
连续纳入292例中风后7天内的患者。在基线以及中风后1、3和6个月时，使用临床淡漠评估量表（AES-C）评估淡漠症状。使用美国国立卫生研究院卒中量表（NIHSS）评分、巴氏指数（BI）评分、简易精神状态检查表（MMSE）评分、汉密尔顿抑郁量表（HAMD）评分和汉密尔顿焦虑量表（HAMA）评分获取人口统计学和临床信息。在基线时测量CRP。使用磁共振成像评估梗死灶的存在和位置。
入院时，基线淡漠与体重指数（BMI）、NIHSS、BI、MMSE、HAMD和CRP显著相关（P < 0.05）。入院时，6个月时的PSA与CRP浓度升高、AES-C高分和BI低分显著相关（P < 0.05）。AES-C评分在中风后3个月达到峰值，但在6个月内下降。
CRP、BMI、MMSE、抑郁和残疾与缺血性中风急性期的淡漠密切相关。较低的BI评分、较高的CRP浓度以及急性中风期的淡漠增加了6个月时PSA的风险。
