Deng Mingzhu, Zhou Nina, Song Kangping, Wang Zhen, Zhao Wei, Guo Jiayu, Chen Sufen, Tong Yangping, Xu Wei, Li Fangyi
Department of Neurology, Brain Hospital of Hunan Province, The Second People's Hospital of Hunan Province, Changsha, Hunan, China.
Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China.
Front Psychiatry. 2024 Jun 28;15:1371578. doi: 10.3389/fpsyt.2024.1371578. eCollection 2024.
Post-stroke depression (PSD) is a well-established psychiatric complication following stroke. Nevertheless, the relationship between early-onset PSD and homocysteine (Hcy) or fibrinogen remains uncertain.
Acute ischemic stroke (AIS) patients who met the established criteria were enrolled in this study. Early-onset PSD was diagnosed two weeks after the stroke. The severity of depressive symptoms was assessed by the Hamilton Depression Scale-17 items (HAMD-17), with patients scored ≥7 assigned to the early-onset PSD group. Spearman rank correlation analysis was employed to evaluate the associations between Hcy, fibrinogen, and HAMD scores across all patients. Logistic regression analysis was conducted to investigate the relationship between Hcy, fibrinogen, and early-onset PSD. Receiver operating characteristic curve (ROC) analysis was ASSDalso performed to detect the predictive ability of Hcy and fibrinogen for early-onset PSD.
Among the 380 recruited patients, a total of 106 (27.89%) patients were diagnosed with early-onset PSD. The univariate analysis suggested that patients in the PSD group had a higher admission National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale score (mRS), Hcy, and fibrinogen levels than patients in the non-PSD group (P<0.05). The logistic regression model indicated that Hcy (odds ratio [OR], 1.344; 95% confidence interval [CI] 1.209-1.494, P<0.001) and fibrinogen (OR, 1.57 6; 95% CI 1.302-1.985, P<0.001) were independently related to early-onset PSD. Area under curve (AUC) of Hcy, fibrinogen, and Hcy combined fibrinogen to predict early-onset PSD was 0.754, 0.698, and 0.803, respectively.
This study indicates that Hcy and fibrinogen may be independent risk factors for early-onset PSD and can be used as predictive indicators for early-onset PSD.
卒中后抑郁（PSD）是卒中后一种公认的精神并发症。然而，早发性PSD与同型半胱氨酸（Hcy）或纤维蛋白原之间的关系仍不明确。
符合既定标准的急性缺血性卒中（AIS）患者纳入本研究。早发性PSD在卒中后两周诊断。采用汉密尔顿抑郁量表17项（HAMD - 17）评估抑郁症状的严重程度，得分≥7分的患者被纳入早发性PSD组。采用Spearman等级相关分析评估所有患者中Hcy、纤维蛋白原与HAMD评分之间的关联。进行逻辑回归分析以研究Hcy、纤维蛋白原与早发性PSD之间的关系。还进行了受试者工作特征曲线（ROC）分析以检测Hcy和纤维蛋白原对早发性PSD的预测能力。
在380例招募的患者中，共有106例（27.89%）患者被诊断为早发性PSD。单因素分析表明，PSD组患者的入院美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表评分（mRS）、Hcy和纤维蛋白原水平均高于非PSD组患者（P<0.05）。逻辑回归模型表明，Hcy（比值比[OR]，1.344；95%置信区间[CI] 1.209 - 表1.494，P<0.001）和纤维蛋白原（OR，1.576；95% CI 1.302 - 1.985，P<0.001）与早发性PSD独立相关。Hcy、纤维蛋白原以及Hcy联合纤维蛋白原预测早发性PSD的曲线下面积（AUC）分别为0.754、0.698和0.803。
本研究表明，Hcy和纤维蛋白原可能是早发性PSD的独立危险因素，可作为早发性PSD的预测指标。
