Relationship Between The Serum Level Of High-sensitivity C-reactive Protein、Interleukin-6 In Acute Phase Of Stroke And The Post-stroke Depression

Objectives:Observe the relationship between the serum level of high-sensitivity C-reactive protein、Interleukin-6 in acute phase of stroke and the post-stroke depression,combined with related risk factors of neurological function deficit scale、cognitive dysfunction and daily life ability damage,to analyze the inflammatory mechanisms and related risk factors of post-stroke depression,and provide more clinical basis for the early prediction and identification of post-stroke depression.Methods:72 acute ischemic stroke patients were consecutively recruited as the case group in accordance with the diagnostic criteria of guide for diagnosis and treatment of acute ischemic stroke in our country(2014),and were confirmed by head MRI diffusion weighted imaging,and followed up to 3 months after stroke.All patients were evaluated according to diagnostic criteria of post-stroke depression and Hamilton Depression Rating Scale 24 version(HAMD-24)at 2 weeks and 3 months after stroke onset.Based on the evaluation results,the case group were divided into post-stroke depression group(PSD group)and no post-stroke depression group(non-PSD group),the PSD group according to HAMD scores were divided into mild PSD group and moderate or major PSD group.Meanwhile,30 healthy persons were recruited as control group.Using enzyme-linked immunosorbent assay to detect the serum level of Interleukin-6,through the immune turbidimetric method to determine serum Hs-CRP levels,and compared the differences of serum index between groups.All patients were performed NIHSS,MMSE and ADL scoresat admission,and analysis the relationship between neurological function deficit scale,cognitive dysfunction,daily life ability damage and PSD.Results:1.The incidence of PSD in 2 weeks and 3 months after stroke onset were 37.5% and32.6% respectively.The cumulative incidence of PSD in 3 months was 58.6%,and mainly composed of mild depression(42.9%).2.IL-6 in serum of PSD group、non-PSD group and control group respectively were(3.69±2.24)pg/ml、(0.98±0.54)pg/ml、(0.91±0.44)pg/ml,Hs-CRP levels respectively were(4.49±4.56)mg/L、(1.29±1.16)mg/L、(1.16±0.79)mg/L,PSD group Hs-CRP and IL-6 level were significantly higher than that in the other two groups,the difference was obvious significant(P<0.01),non-PSD group Hs-CRP and IL-6 level were slightly higher than the control group,but there was no significant difference(P>0.05).IL-6 in serum of moderate or major PSD group and mild PSD group respectively were(6.79±1.79)pg/ml、(2.55±0.91)pg/ml,Hs-CRP levels respectively were(7.14±6.02)mg/L、(3.52±3.55)mg/L,there were significant differences between groups(P<0.01).3.NIHSS scores of moderate or major PSD group、mild PSD group and non-PSD group respectively were 8.82±3.49、4.27±2.61、2.34±1.26,ADL scores respectively were43.00±8.64、28.43±9.38、18.41±5.51,there were significant differences between groups(P < 0.01).MMSE score of moderate or major PSD group 、 mild PSD group and non-PSD group respectively were 23.00±4.94、26.20±3.96、27.24±2.63,MMSE scores in moderate or major PSD group were significantly lower than that of mild PSD group and non-PSD group,the difference was obvious significant(P<0.01),mild PSD group MMSE scores were slightly lower than that of non-PSD group,but there was no significant difference(P>0.05).4.The level of Hs-CRP 、 IL-6 、 NIHSS scores and ADL scores were positively correlated with HAMD scores(r=0.518,r=0.785,r=0.639,r=0.702,P<0.01),while MMSE scores were negatively correlated with HAMD scores(r=﹣0.322,P<0.01).Conclusions:1.The cumulative incidence of PSD in 3 months was too higher(58.6%),and mainly composed of mild depression.2.PSD patients’ expression of inflammatory cytokines(Hs-CRP、IL-6)increased significantly,and related to the degree of depression.This show inflammatory cytokines may be involved in the occurrence of PSD.3.Severe neurological impairment、daily life ability damage and obvious cognitive dysfunction are related with PSD.