Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
J Affect Disord. 2019 Mar 1;246:105-111. doi: 10.1016/j.jad.2018.12.012. Epub 2018 Dec 10.
Post-stroke depression (PSD) is the most common psychological consequence among stroke patients, and inflammatory cytokines have cited as risk factors in PSD. We aimed to evaluate the predictive value of stratification of PLR (platelet-to-lymphocyte ratio), an inflammatory marker, in PSD patients.
A total of 363 acute ischemic stroke (AIS) patients were screened in the study and received 1-month follow-up. All of the patients were categorized into equal tertiles according to the number of patients and the distribution of PLR. PSD status was evaluated by 17-item Hamilton Depression Rating Scale at 1 month after stroke RESULTS: The optimal cut-off points of PLR were: (T1) 42.15-99.60, (T2) 99.72-127.92, (T3) 127.93-259.84. A total of 77 patients (21.2%) were diagnosed with PSD at 1-month follow-up. Significant differences were found between the PSD and non-PSD groups in PLR tertiles of patients (P < 0.001). After adjustment for conventional confounding factors, the odds ratio of PSD was 5.154 (95% CI, 1.933-13.739) for the highest tertile of PLR compared with the lowest tertile. In multiple-adjusted spline regression, continuously PLR showed linear relation with PSD risk after 95 (P < 0.001 for linearity).
We excluded patients with severe aphasia or serious conditions. In addition, the PLR was recorded only at admission, which limited us explore the correlation of the change of PLR over time with PSD CONCLUSIONS: Increased PLR at admission is a significant and independent biomarker to predict the development of PSD, and stratified PLR could strengthen the predictive power for PSD patients.
卒中后抑郁（PSD）是卒中患者最常见的心理后果，炎症细胞因子已被认为是 PSD 的危险因素。我们旨在评估血小板与淋巴细胞比值（PLR）分层作为 PSD 患者的预测因子的预测价值。
本研究共筛选了 363 例急性缺血性卒中（AIS）患者，并进行了 1 个月的随访。所有患者根据 PLR 的数量和分布分为相等的三分位数。PSD 状态在卒中后 1 个月通过 17 项汉密尔顿抑郁量表（HAMD）评估。
PLR 的最佳截断点为：（T1）42.15-99.60，（T2）99.72-127.92，（T3）127.93-259.84。共有 77 例患者（21.2%）在 1 个月的随访中被诊断为 PSD。PSD 组和非 PSD 组在患者的 PLR 三分位数之间存在显著差异（P<0.001）。在调整了常规混杂因素后，与最低三分位数相比，PLR 最高三分位数的 PSD 比值比为 5.154（95%可信区间，1.933-13.739）。在多元调整的样条回归中，连续 PLR 与 PSD 风险呈线性关系，95%可信区间的 P 值<0.001。
我们排除了严重失语症或严重疾病的患者。此外，PLR 仅在入院时记录，这限制了我们探索 PLR 随时间变化与 PSD 的相关性。
入院时 PLR 升高是 PSD 发生的一个显著且独立的生物标志物，分层 PLR 可以增强 PSD 患者的预测能力。
