| Objective:Inflammatory immune response is still the research hotspot and focus of the etiology mechanism of post-stroke depression(PSD).Tumor necrosis factor-like weak inducer of apoptosis(TWEAK)is one of the new members of the tumor necrosis factor superfamily,through which fibroblast growth factor 14(Fn14)binding produces a variety of biological effects such as stimulating cell proliferation,neovascularization,and induction of proinflammatory cytokine production.It participate in the development of PSD.It will become a potential biomarker probably.Observe the relationship between the serum level of TWEAK 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 it is helpful to provide certain experiment basis for the prediction and individualized diagnosis and treatment of post-stroke depression.Methods:153 acute ischemic stroke patients were consecutively recruited as the case group in accordance with the diagnostic criteria of the fourth national cerebrovascular disease conference and were confirmed by head MRI diffusion weighted imaging.Based on the 2016 China expert consensus on poststroke depression in clinical practice and the evaluation results of Hamilton Depression Rating Scale 24 version(HAMD-24),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,40 healthy persons were recruited as control group.All the groups were extracted venous blood samples,and using enzyme-linked immunosorbent assay to detect the serum level of TWEAK.Use variance analysis and LSD-t test to compare the difference of the serological indexes among different groups.All patients were performed NIHSS,MMSE and ADL scores at admission,and apply Pearson correlation analysis to figure out the relationship between neurological function deficit scale,cognitive dysfunction,daily life ability damage and PSD.Results:1.The incidence of PSD: 153 patients met the inclusion criteria,and 58 cases were diagnosed as PSD in 7-14 days after stroke.The incidence of PSD in 7-14 days after stroke onset was 37.9%,where in mild depression 47(81.0%),moderate depression 10(17.2%),severe depression 1(1.7%).2.The serum level of TWEAK comparison between group: TWEAK in serum of PSD group?non-PSD group and control group respectively were(1146.78±341.00)pg/ml?(697.15±56.02)pg/ml and(665.62±71.87)pg/ml,PSD group TWEAK level was significantly higher than that in the other two groups,the difference was statistically significant(P<0.01),non-PSD group TWEAK level was slightly higher than the control group,but the difference was not statistically significant(P>0.05).TWEAK in serum of mild PSD group and moderate or major PSD group respectively were(1010.40±170.46)pg/ml and(1729.50±261.13)pg/ml,the difference was statistically significant(P<0.01).3.HAMD score and correlation analysis of each index: NIHSS scores of non-PSD group?mild PSD group and moderate or major PSD group respectively were 2.80±1.52?5.17±2.47?10.00±3.19,ADL scores respectively were 20.20±5.44?27.06±10.14?41.27±8.84,MMSE scores respectively were 27.13±2.38?25.23±3.66?22.00±5.53,the differences between the groups were statistically significant(P<0.01?P<0.01?P<0.05).HAMD scores were positively correlated with the level of TWEAK(r=0.944,P<0.01),NIHSS scores(r=0.676,P<0.01)and ADL scores(r=0.666,P<0.01),while HAMD scores were negatively correlated with MMSE scores(r=-0.403,P<0.01).Conclusion:The serum level of TWEAK during acute ischemic stroke had be associated with PSD.With the increase of the severity of depression,TWEAK levels also increase obviously.Severe neurological impairment ? daily life ability damage and obvious cognitive dysfunction are correlated with PSD. |
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