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急性缺血性中风患者的血脂谱与中风后抑郁

Serum lipid profiles and post-stroke depression in acute ischemic stroke patients.

作者信息

Shen Huiping, Tu Xinjie, Luan Xiaoqian, Zeng Yaying, He Jincai, Tang Wenjie

机构信息

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, People's Republic of China.

First School of Clinical Medicie, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2019 Jun 17;15:1573-1583. doi: 10.2147/NDT.S204791. eCollection 2019.

Abstract

Post-stroke depression (PSD) is a psychiatric complication after stroke that leads to poorer stroke outcomes. Recent observational studies have indicated that lipid profiles were associated with a higher risk of stroke and depression. This study aims to further explore the possible relationship between serum lipid profiles and the development of PSD. A total of 373 acute ischemic stroke patients were examined. Serum lipid profiles including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were measured within 24 hrs of admission. Depression symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17) at the one-month follow-up, and HAMD scores ≥7 indicated a diagnosis of PSD. A total of 114 patients were diagnosed with PSD at the one-month follow-up, for a percentage of 30.6%. There were significant differences in HDL-C levels (<0.001), LDL-C levels (=0.002) and the LDL/HDL ratio (<0.001) between the PSD and non-PSD groups, but no differences were observed in TGs, TC, Apo A1 or Apo B. Low serum HDL-C levels (r = -0.157, <0.001) and elevated LDL-C levels (r =0.139, =0.002) and the LDL/HDL ratio (r =0.227, <0.001) were associated with HAMD scores. After adjusting for the NIHSS score, BI score, mRS score and alcohol consumption in the logistic analysis, low HDL-C levels and the highest quartile (≥3.07) of the LDL/HDL ratio were independently associated with the development of PSD (OR =0.250, 95% CI, 0.077-0.813, =0.021 and OR =1.874, 95% CI, 1.050-3.347, =0.034, respectively). Decreased levels of HDL-C and elevated levels of LDL/HDL ratio are associated with PSD. HDL-C and the LDL/HDL ratio are independent predictors of PSD.

摘要

中风后抑郁(PSD)是中风后的一种精神并发症,会导致更差的中风预后。最近的观察性研究表明,血脂水平与中风和抑郁的较高风险相关。本研究旨在进一步探讨血清血脂水平与PSD发生之间的可能关系。共检查了373例急性缺血性中风患者。在入院24小时内测量血清血脂水平,包括高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、载脂蛋白A1(Apo A1)和载脂蛋白B(Apo B)。在1个月随访时通过17项汉密尔顿抑郁量表(HAMD-17)评估抑郁症状,HAMD评分≥7表明诊断为PSD。在1个月随访时,共有114例患者被诊断为PSD,占比30.6%。PSD组和非PSD组之间的HDL-C水平(<0.001)、LDL-C水平(=0.002)和LDL/HDL比值(<0.001)存在显著差异,但在TG、TC、Apo A1或Apo B方面未观察到差异。低血清HDL-C水平(r = -0.157,<0.001)、升高的LDL-C水平(r =0.139,=0.002)和LDL/HDL比值(r =0.227,<0.001)与HAMD评分相关。在逻辑分析中调整NIHSS评分、BI评分、mRS评分和饮酒情况后,低HDL-C水平和LDL/HDL比值的最高四分位数(≥3.07)与PSD的发生独立相关(OR =0.250,95%CI,0.077 - 0.813,=0.021和OR =1.874,95%CI,1.050 - 3.347,=分别为0.034)。HDL-C水平降低和LDL/HDL比值升高与PSD相关。HDL-C和LDL/HDL比值是PSD的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c6/6589522/7d71e9e107c3/NDT-15-1573-g0001.jpg

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