| Purpose: Post-stroke depression(PSD) is a common complication of stroke. PSD is often overlooked by the clinicians of general hospitals as the treatment and rehabilitation of limb exercise, feeling and language disorder are much concerned, while is short of standard of diagnosis and examination means. This study attempts, by determining the homocysteine(Hcy) of both PSD patients and non-PSD patients in patients with stroke as well as P300 potential detection, to explicit the relationship between both the two and PSD. Also,comparison of sensitivity and specificity of PSD between the patients with hyperhomocysteinemia(HHcy) and abnormal in P300 is performed, to offer objective basis for the early detection, early diagnosis and early intervention of PSD.Methods: 150 cases of patients of stroke who were hospitalized in Neurology Department of the Affiliated Hospital of Hebei University from June 2013 to March 2014 and completed for one-year follow-up were enrolled. These cases were divided into PSD group and non-PSD group(NPSD) based upon whether the PSD appeared or not. Diagnostic standard of stroke referred to the Diagnostic Essential of Cerebrovascular Diseases revised in the 4th National Conference on Cerebrovascular Disease of CMA in 1995, while the diagnostic standard of PSD adopted the standard in Article 31 Depressive State of Chinese Classification of Mental Disorders and Diagnostic Criteria(CCMD-3). The differences of incubation and amplitude in the Hcy levels and P300 detection results between the two groups were compared; analyze the differentiation of cases of HHcy and number of P300 abnormality in PSD group. SPSS16.0 was employed for statistical treatment, while χ2-test was used for enumeration data and measurement data was expressed by x ±s; the completely randomized design t-test was used for the comparison between two groups, and paired t-test was for comparison made before and after treatment in same group. Moreover, Pearson bivariate correlation was also used to analyze the relations between two variables, showing statistically significance as P<0.05.Results: 1. 150 cases of patients with stroke were collected in this study, where there were 55 cases for PSD group, and 95 cases for NPSD group, and the incidence of PSD in this study was 36.67%. Patients in PSD group were 24 males(43%) and 31 females(57%), with the average age of 65.45±9.49 years old; while NPSD group had 46 males(48%) and 49females(52%), with the average age of 64.50±8.99 years old, and there’s no statistically significant difference between two groups with respect to age and gender. And the comparison between the groups in relation to weight, height, BMI value, smoking & drinking, education years, hypertension, coronary artery disease and diabetes showed no significant difference(P>0.05), while the statistically significant different existed in terms of recent negative live event, previous history of stroke, NIHSS score(P<0.05).2. As for the comparison of sites of stroke, among the 150 patients with stroke, there were 43 cases showing pathogenic site at left, of which PSD occurred in 21 cases, with incidence of 48.87%; 46 cases showing pathogenic site at right, of which PSD occurred in 10 cases, with incidence of 21.73%; and 61 cases had their pathogenic sites on both sides, where PSD occurred in 24 cases, with incidence of 39.34%; the results presented significant difference(χ2=7.34, P<0.05).3. Hcy level in PSD group was 25.73±13.81μmol/L, and it in NPSD group was14.77±8.54μmol/L, presenting statistically significant difference(t=6.28, P<0.05). In PSD group, there were 36 cases of HHcy patients(Hcy level>20μmol/L), and 17 cases of HHcy patients; while in NPSD groups, there were 39 cases of HHcy patients and 56 cases of HHcy patients; the difference between the groups was statistically significant(χ =8.29, P<0.05).HAMD score in PSD and NPSD groups were 12.38±4.53 and 4.16±1.29, respectively,showing the statistically significant difference(t=16.50, P<0.01).4. Average incubation period of P300 in PSD group was 405.96±26.10 ms, with average amplitude of 4.83±1.87 u V; and those for NPSD group was 343.28±18.55 ms and 9.56±2.71 u V, respectively, and the difference between two group in those respects was significant(t=17.03, P<0.05; t=11.42, P<0.05). The P300 incubation period of patients in PSD group was positively correlated with the HAMD score(r=0.901, P<0.01), while the amplitudedemonstrated a negative correlation with HAMD score(r=-0.690, P<0.01).5. We also performed a comparison of sensitivity and specificity of PSD between the patients with hyperhomocysteinemia(HHcy) and P300. Into the group of cases, a total of 73 patients with HHcy, with 36 cases in the PSD group, NPSD group of 37 cases,the result of Hcy concentration test’s sensitivity is 58.18%,95%CI(0.4513 to 0.7123);the specificity is56.84%,95%CI(0.5583 to 0.5782)。Both of two groups, there are abnormal 62 cases,with 49 cases in the PSD group, NPSD group of 23 cases,the result of P300 test’s sensitivity is89.09%,95%CI(0.8085 to 0.9732);the specificity is 86.31%,95%CI(0.7939 to 0.9322)。Conclusion:1. PSD is the primary complication of patients with stroke in spiritual and emotional activities, with the incidence of 36.67%. PSD incidence is correlated with the stroke sites,history of stroke, severity and recent negative live event, and there’s no statistically significant difference for other basic data;2. Stroke accompanied by hyperhomocysteinemia(HHcy) will improve the occurrence of PSD.3. Results of P300 in ERPs can provide objective evidence for the PSD detection and diagnosis. |
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