脑卒中后抑郁患者视黄醇结合蛋白4和结合珠蛋白的研究

目的:通过观察脑卒中后抑郁(post-stroke depression,PSD)患者血清结合珠蛋白(Hp)和视黄醇结合蛋白4(RBP4)的水平变化,进一步明确PSD可能的作用机理。方法:以缺血性脑卒中患者为研究对象,采用汉密尔顿抑郁量表(HAMD)筛选符合条件的卒中后抑郁患者35例,选择不伴抑郁的卒中病人35例为对照组。于住院第3周,应用酶联免疫吸附法检测病人血清Hp和RBP4的水平。结果:卒中后抑郁组血清Hp和RBP4浓度分别为(130.89±15.86)mg/L、(36.45±5.02)mg/L]较对照组分别为(92.42±15.74)mg/L、(28.57±5.08)mg/L]明显增高,差异有显著性意义(P0.05)。脑卒中后重度抑郁组血清Hp和RBP4的水平分别为(146.83±10.08)mg/L、(40.83±4.28)mg/L]显著高于轻度抑郁组分别为(113.67±9.18)mg/L、(31.76±4.11)mg/L]及中度抑郁组分别为(130.73±5.11)mg/L、(36.37±1.17)mg/L],中度抑郁组亦高于轻度抑郁组(P0.05)。血清Hp和RBP4水平与HAMD评分的Pearson相关分析表明两者显著相关(相关系数分别为:r=0.913、P0.01;r=0.800、P0.01)。结论:PSD组中血清Hp和RBP4水平相对于对照组有明显增高,并且该组中Hp和RBP4的水平变化与抑郁程度显著正相关,提示血清Hp和RBP4可能在脑卒中后抑郁的发病机理中起着重要作用,并在一定程度上可反映脑卒中后抑郁的严重程度,并指导临床诊疗。

Study on the SerumRBP4 and Hp in the Patients with Post-stroke Depression*

Objective： Through explore the change of the serum levels of Hp and RBP4 in patients with post-stroke depression（P- SD） can further clarify the possible biological mechanism. Methods： By using Hamilton Rating Scale for Depression（HAMD）, 35 patients with post-stroke depression were recruited, and 35 patients without depression were divided into the control group. Two weeks after the onset of stroke, serum levels of Hp and RBP4 were measured by enzyme-linked immunosorbent assay（ELISA）. Results： The levels of Hp and RBP4 in patients with PSD were significantly higher than that of the control group （130.89± 15.86 mg/L vs 92.42± 15.74 mg/L, P=-0.000; 36.45± 5.02 mg/L vs 28.57± 5.08 mg/L, p=0.000 respectively）. Pearson correlation analysis showed the serum levels of lip and RBP4 were positively correlated with the HAMD score（r=0.913, P〈0.01; r=0.800, P〈0.01 respectively）. The serum levels of lip and RBP4 in patients with serious depression were higher than that in moderate and mild depression groups （146.83± 10.08 mg/L vs 130.73 ± 5.11 mg/L vs 113.67± 9.18 mg/L, 40.83± 4.28 mg/L vs 36.37± 1.17 mg/L vs 31.76± 4.11 mg/L）, and that in moderate depression group were higher than that in mild depression group （all P〈0.01）. Conclusion： The serum levels of lip and RBP4 in depression group was increased obviously than the control group, and it was positive correlation with the degree of depression significantly. The serum cytokines Hp and RBP4 maybe play an important role in pathogenesis of post-stroke depression, and may be the markers of post-strok depression, all of that can guide the diagnosis and the treatment in clinical.