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中国全科医学 ›› 2018, Vol. 21 ›› Issue (16): 1974-1979.DOI: 10.3969/j.issn.1007-9572.2018.16.014

所属专题： 精神卫生最新文章合辑； 神经系统疾病最新文章合辑； 脑健康最新研究合辑

• 专题研究 • 上一篇    下一篇

血清尿酸水平对急性缺血性脑卒中后抑郁的预测价值研究

苑杰1，路月英1，郭鑫1，贾娜娜1，王丽萍2，王刚2，王静3*   

  1. 1.063000河北省唐山市，华北理工大学附属医院　2.063000河北省唐山市，开滦精神卫生中心　3.063000河北省唐山市，唐山职业技术学院
    *通信作者：王静，教授；E-mail：mdwangjing@126.com
  • 出版日期:2018-06-05 发布日期:2018-06-05

Predictive Value of Serum Uric Acid on the Depression after Acute Ischemic Stroke　

  1. 1.Affiliated Hospital of North China University of Science and Technology，Tangshan 063000，China
    2.Kailuan Mental Health Center，Tangshan 063000，China
    3.Tangshan Vocational and Technical College，Tangshan 063000，China
    *Corresponding author：Wang Jing，Professor；E-mail：mdwangjing@126.com
  • Published:2018-06-05 Online:2018-06-05

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摘要： 目的　探讨入院时血清尿酸水平对急性缺血性脑卒中患者6个月内出现抑郁的预测价值。方法　选取2015年8月—2016年12月于华北理工大学附属医院住院治疗的急性缺血性脑卒中患者498例为研究对象。卒中后6个月应用汉密尔顿抑郁量表（HAMD）对被评定者进行检查，总分<7分为非卒中后抑郁（PSD）组（283例），总分≥7分为PSD组（168例）。收集两组患者一般临床资料、神经功能评价结果、实验室指标，比较两组上述指标的差异；采用Logistic回归分析急性缺血性脑卒中PSD的影响因素，分析血清尿酸水平对急性缺血性脑卒中PSD的预测价值。结果　PSD组男性所占比例低于非PSD组，平均年龄、精神疾病家族史、合并冠心病、合并高脂血症、首次发病者所占比例高于非PSD组，差异有统计学意义（P<0.05）；PSD组美国国立卫生研究院卒中量表（NIHSS）评分、日常生活活动能力量表（ADL）评分、改良Rankin量表（mRS）评分高于非PSD组，差异有统计学意义（P<0.05）；PSD组总胆固醇、三酰甘油水平高于非PSD组，血清尿酸水平低于非PSD组，两组血清尿酸水平分组构成不同，差异有统计学意义（P<0.05）。Logistic回归分析结果显示，性别、年龄、合并冠心病、脑卒中发生次数、mRS评分、血清尿酸水平是急性缺血性脑卒中PSD的影响因素（P<0.05）。结论　血清尿酸水平是急性缺血性脑卒中PSD的独立影响因素，对急性缺血性脑卒中6个月内抑郁的发生有预测作用。

关键词: 卒中, 抑郁, 尿酸, 预测

Abstract: Objective　To investigate the value of serum uric acid（UA） levels on admission to predict the occurrence of post-stroke depression（PSD） at 6 months after acute ischemic stroke（AIS）．Methods　The study cohort included 498 patients with AIS who were hospitalized in the Affiliated Hospital of North China University of Science and Technology from August 2015 to December 2016.Six months after AIS，the Hamilton Rating Scale for Depression（HAMD） was used to evaluate the patients.Patients with a total HAMD score of <7 were assigned to the non-PSD group（283 cases） and those witha total HAMD score of ≥7 were assigned to the PSD group（168 cases）．General clinical data，neurological assessment results，and serum biochemical indicators were collected and compared between the two groups.Logistic regression was used to analyze the influencing factors of PSD and the predictive value of serum UA levels for PSD was assessed.Results　The proportion of males was lower in the PSD group than in the non-PSD group，while the average age of the patients，proportion of the patients with a family history of mental illness，complication of coronary heart disease or hyperlipidemia，proportion of the patients with first onset of the condition were higher in the PSD group than in the non-PSD group（P<0.05）．Moreover，National Institutes of Health Stroke Scale（NIHSS）score，Activities of Daily Living（ADL）score and the modified Rankin scale（mRS） score，were higher in the PSD group than in the non-PSD group（P<0.05）．In terms of biochemical indicators，cholesterol and triacylglycerol levels were higher and serum UA levels were lower in the PSD group than in the non-PSD group，while there were significant differences in the constitutions of patients with different UA levels（P<0.05）．Logistic regression analysis showed that sex，age，history of coronary heart disease，number of strokes，mRS，and UA level were influencing factors for PSD（P<0.05）．Conclusion　Serum UA level is an independent risk factor for PSD and is predictive of the occurrence of PSD among 6 months after AIS.

Key words: Stroke, Depression, Uric acid, Forecasting

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