Hu Jia, Zhou Wei, Zhou Zhiming, Yang Qian, Han Jian, Yan Yan, Dong Wanli
Department of Neurology, Yijishan Hospital, Wuhu 241001, China.
Department of Cardiovascular Surgery, Yijishan Hospital, Wuhu 241001, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2019 Jun 30;39(6):665-671. doi: 10.12122/j.issn.1673-4254.2019.06.06.
To investigate the association of venous blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and levels of interleukin-17 (IL-17) and IL-6 at 2 weeks after admission with the occurrence of post-stroke depression (PSD) in patients with first-ever acute ischemic stroke.
The hospitalized patients with first-ever acute ischemic stroke were recruited consecutively from the Department of Neurology of Yijishan Hospital from March, 2015 to September, 2017. The demographic and baseline clinical data on admission and the imaging data were collected. The diagnosis of PSD was established in line with DSM-IV (SCID-I-R) at 3 months during the follow-up. The severity of PSD was assessed using the Hamilton Depression Scale (HAMD-17). Multivariate logistic regression analysis was used to investigate the correlation of NLR, PLR, IL-17, and IL-6 with PSD in these patients.
A total of 376 patients with acute ischemic stroke were enrolled, including 224 male patients (59.57%) and 152 female patients (40.43%), whose mean age was 61.37±10.34 years. Of these patients 104 (27.66%) were found to have PSD. Univariate analysis showed that gender, years of education, BMI, widowhood, NIHSS score, MMSE score, mRS score, and laboratory indexes (NLR, PLR, IL-17, and IL-6) were all significantly correlated with PSD (all < 0.05). Multivariate logistic regression analysis showed that, after adjusting for the compounding factors, the third quartile of NLR ( < 0.001), the third quartile of PLR (=0.002), IL-17 (=0.025) and IL-6 (=0.016) were independent factors that predicted the occurrence of PSD.
Elevated NLR and PLR at admission and levels of IL-17 and IL-6 at 2 weeks after admission are all independent predictors of the occurrence of PSD at 3 months after stroke.
探讨首次急性缺血性脑卒中患者入院2周时静脉血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及白细胞介素-17(IL-17)和白细胞介素-6水平与卒中后抑郁(PSD)发生的相关性。
连续纳入2015年3月至2017年9月在弋矶山医院神经内科住院的首次急性缺血性脑卒中患者。收集患者入院时的人口统计学和基线临床资料以及影像学资料。随访3个月时依据《精神疾病诊断与统计手册》第四版(SCID-I-R)标准诊断PSD。采用汉密尔顿抑郁量表(HAMD-17)评估PSD的严重程度。运用多因素logistic回归分析探讨这些患者中NLR、PLR、IL-17和IL-6与PSD的相关性。
共纳入376例急性缺血性脑卒中患者,其中男性224例(59.57%),女性152例(40.43%),平均年龄61.37±10.34岁。这些患者中104例(27.66%)被发现患有PSD。单因素分析显示,性别、受教育年限、体重指数、丧偶、美国国立卫生研究院卒中量表(NIHSS)评分、简易精神状态检查表(MMSE)评分、改良Rankin量表(mRS)评分及实验室指标(NLR、PLR、IL-17和IL-6)均与PSD显著相关(均P<0.05)。多因素logistic回归分析显示,校正混杂因素后,NLR的第三个四分位数(P<0.001)、PLR的第三个四分位数(P=0.002)、IL-17(P=0.025)和IL-6(P=0.016)是预测PSD发生的独立因素。
入院时升高的NLR和PLR以及入院2周时IL-17和IL-6水平均是卒中后3个月PSD发生的独立预测因素。