Risk Analysis Of Acute Post-stroke Depression At High Altitude

Objective:To explore the incidence of acute post-stroke depression(PSD)and risk factors at high altitude.Methods:100 and 60 native Han nationality patients with acute cerebral hemorrhage and atherosclerotic cerebral infarction were selected respectively from affiliated hospital of Qinghai university(about 2200 m height)and Hainan Tibetan autonomous prefecture hospital(about 3000 m height),relative clinical data were collected,HDRSl7,NIHSS,PSQI were scored,Nephelometry and ELISA were used to determine the concentration of serum hs-CRP,IL-6 and TNF-? respectively.Patients were divided into PSD and non-PSD group according to depression diagnostic criterion of DSM-IV,risk factors of PSD were analyzed and compared between medium and high altitude.Results:Total incidence rate of PSD was 24.4%,compared with incidence rate of PSD of two area,the differences had no statistical significance(P>0.05).Ratio of female and hypertension were higher in PSD group than those of non-PSD group,the differences had statistical significance(P<0.05).Female,hypertension,serum level of hs-CRP,IL-6 and TNF-? are risk factors of PSD.With the aggrevation of depression degree,the serum level of hs-CRP,IL-6 and TNF-? increased.The serum level of hs-CRP,IL-6 and TNF-? of high altitude were higher than those of medium altitude(5.37±1.90mg/L vs 3.93±1.53mg/L,18.34±3.21ng/L vs 16.33±2.77ng/L,81.94±9.63ng/L vs 74.70±8.05ng/L,P<0.05),the HDRSl7 and PSQI score of high altitude were higher than those of medium altitude(18.62±3.54 vs 15.21±4.85,15.75±3.90 vs 12.36±5.02,P<0.05).Conclusions:Incidence rate of PSD at high altitude is consistent with the result ofplain area,Female,hypertension,serum level of hs-CRP,IL-6 and TNF-? are risk factors of PSD,inflammation and sleep quanlity play a role in the development of acute PSD.