[1]董汉宁a,彭芸娟a,雷国奇b,等.急性缺血性脑卒中患者血清sTREM2 和DKK-1 水平检测对抑郁发生的预测价值研究[J].现代检验医学杂志,2023,38(06):136-141.[doi:10.3969/j.issn.1671-7414.2023.06.025]
　DONG Hanninga,PENG Yunjuana,LEI Guoqib,et al.Predictive Value of Serum sTREM2 and DKK-1 Levels in Patients with Acute Ischemic Stroke for the Occurrence of Depression[J].Journal of Modern Laboratory Medicine,2023,38(06):136-141.[doi:10.3969/j.issn.1671-7414.2023.06.025]
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急性缺血性脑卒中患者血清sTREM2 和DKK-1 水平检测对抑郁发生的预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
136-141
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Predictive Value of Serum sTREM2 and DKK-1 Levels in Patients with Acute Ischemic Stroke for the Occurrence of Depression
文章编号:
1671-7414（2023）06-136-06
作者:
董汉宁a; 彭芸娟a; 雷国奇b; 艾艳萍c; 方足兵a
（武汉市汉口医院 a. 心理康复科；b. 中医科；c. 神经内科，武汉 430012）
Author(s):
DONG Hanninga;  PENG Yunjuana;  LEI Guoqib;  AI Yanpingc;  FANG Zubinga
(a. Department of Psychological Rehabilitation；b. Department of Traditional Chinese Medicine; c. Department of Neurology,Wuhan Hankou Hospital, Wuhan 430012, China)
关键词:
急性缺血性卒中; 可溶性髓细胞表达触发受体2; Wnt 信号通路抑制因子1
分类号:
R743.33；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.025
文献标志码:
A
摘要:
目的 研究急性缺血性脑卒中（acute ischemic stroke，AIS）患者血清可溶性髓细胞表达触发受体2(solubletriggering receptor expressed on myeloid cells 2，sTREM2) 及Wnt 信号通路抑制因子1(DKK-1) 水平对抑郁发生的预测价值。方法 选取2019 年1 月～ 2021 年1 月于武汉市汉口医院住院治疗的AIS 患者251 例为研究对象。根据卒中后6个月汉密尔顿抑郁量表（Hamilton depression scale，HAMD）评分，将AIS 患者分为非卒中后抑郁（NPSD）组（<7 分，n=183）和卒中后抑郁（PSD）组（≥ 7 分，n=68）。比较两组一般临床资料、神经功能评分及实验室检查指标的差异。相关性分析采用Pearson 相关分析。多因素Logistic 回归分析影响AIS 患者PSD 发生的影响因素。受试者工作曲线分析血清sTREM2，DKK-1 及联合检测对AIS 患者PSD 的预测价值。结果 PSD 组患者血清sTREM2（312.79±51.24 ng/L），DKK-1（4.47±0.62μg/L），美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin 量表（mRS）评分均高于NPSD 组（172.96±32.55 ng/L，3.01±0.57μg/L），日常生活活动能力量表（ADL）评分明显低于NPSD 组，差异均有统计学意义(t=25.585，17.607，5.937，47.288，2.990，均P<0.05）。PSD 组血清sTREM2，DKK-1 水平与NIHSS评分、mRS 评分均呈显著正相关(r=0.657，0.669；0.620，0.614，均P<0.05)，与ADL 评分呈显著负相关(r=-0.712，-0.701，均P<0.05)。sTREM2(OR=1.219，95%CI=1.040 ～ 1.429) 升高，DKK-1(OR=1.363，95%CI=1.076 ～ 1.728) 升高是影响AIS 患者PSD 发生的独立危险因素（P ＜ 0.05）。血清sTREM2，DKK-1 两者联合对AIS 患者PSD 的预测曲线下面积（95%CI）为0.914（0.843 ～ 0.967），高于血清sTREM2，DKK-1 单一指标检测[0.823（0.760 ～ 0.869），0.801（0.743 ～ 0.851）]，差异具有统计学意义（Z=3.864，4.072，均P<0.05）。结论 血清sTREM2 和DKK-1 水平升高是AIS 患者PSD 的独立影响因素，对AIS 发生6 个月内抑郁的发生有预测作用。
Abstract:
Objective To investigate the predictive value of serum soluble triggering receptor expressed on myeloid cells 2 (sTREM2) and Wnt signaling pathway inhibitor 1 (DKK-1) levels in the occurrence of depression in patients with acute ischemic stroke (AIS). Methods 251 patients with AIS who were hospitalized in Wuhan Hankou Hospital from January 2019 to January 2021 were selected as the study subjects. According to the Hamilton depression scale（HAMD）score at 6 months after stroke, patients with AIS were divided into a non-post stroke depression (NPSD) group (<7 points, n=183) and a post stroke depression (PSD) group ( ≥ 7 points, n=68). The differences of general clinical data, neurological function scores and laboratory test indexes between the two groups were compared. Pearson correlation analysis was used for correlation analysis. Multivariate logistic regression analysis was used to analyze the influencing factors of PSD in AIS patients. The predictive value of serum sTREM2, DKK-1 and their combined detection on PSD in patients with AIS was analyzed by receiver operating curve analysis. Results The serum sTREM2（312.79±51.24 ng/L），DKK-1（4.47±0.62μg/L）, NIHSS scores and mRS scores in PSD group were higher than those in NPSD group（172.96±32.55 ng/L，3.01±0.57μg/L）, and the ADL scores were significantly lower than those in NPSD group (t=25.585，17.607，5.937，47.288，2.990，all P<0.05). In PSD group, serum sTREM2 and DKK-1 levels were significantly positively correlated with NIHSS score and mRS score(r=0.657，0.669；0.620，0.614，all P<0.05), and significantly negatively correlated with ADL score (r=-0.712，-0.701，all P<0.05). The elevation of sTREM2 (OR=1.219，95%CI=1.040 ～ 1.429) and DKK-1 (OR=1.363，95%CI=1.076 ～ 1.728) were independent risk factors for PSD in patients with acute ischemic stroke (P<0.05). The predictive area under the curve (95% CI) of serum sTREM2 and DKK-1 combination for PSD in AIS patients was 0.914 (0.843 ～ 0.967), and significantly higher than serum sTREM2, DKK-1 single index detection 0.823 (0.760 ～ 0.869), 0.801 (0.743 ～ 0.851) (Z=3.864, 4.072, all P<0.05). Conclusion The elevation of serum sTREM2 and DKK-1 levels is an independent influencing factor of PSD in AIS, which can predict the occurrence of depression within 6 months after AIS.

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备注/Memo

备注/Memo:
基金项目： 武汉市卫生和计划生育委员会项目（编号：WX18D33）：基于计算机的认知训练结合穴位按摩对脑器质性精神障碍患者的认知功能的影响研究。
作者简介：董汉宁（1977-），男，本科，副主任医师，研究方向：精神障碍的中西医及物理治疗，E-mail：donghanning73@163.com。
更新日期/Last Update: 2023-11-15