| Objective: Post-stroke depression(PSD)is a common complication after stroke.There are many factors related to PSD.The purpose of this experiment is to observe the relationship between the level of the indicator of serum oxidative stress-8-isoprostanes-F2?(8-iso-PGF2?)-and the occurrence and severity of post-stroke depression in patients with acute ischemic stroke.And then evaluate whether 8-iso-PGF2? can be used as an early predictor of post-stroke depression.Methods:A total of 143 patients with acute ischemic stroke who were hospitalized in our department of neurology from April 2018 to November 2018 were enrolled.53 patients with post-stroke depression(PSD group)and 90 patients with post-stroke depression(NPSD group)were selected.In the same time,33 subjects in the physical examination center of our hospital were selected as the control group.The blood samples of the enrolled patients were taken from the fasting elbow vein,and the level of serum 8-iso-PGF2? was measured by enzyme-linked immunosorbent assay(ELISA).At the same time,general patient data were collected and cognitive function and neurological deficit degree were performed.Results: 1 A total of 143 cases were collected in this trial.A total of 53 patients with PSD were diagnosed,and the incidence rate was 37.1%.Among them,36 cases(67.9%)had mild depression,16 cases(30.2%)had moderate depression,and 1 case(1.9%)had severe depression.A total of 33 controls that matched the basic data of the case group were collected.2 General clinical data analysis 2.1 The general data of case group and control group: In this study,143 patients with acute ischemic stroke were enrolled,including 95 males and 48 females,aged 28-79 years,with an average age of(57.94±10.61)years old.108 patients were associated with hypertension,38 with diabetes,and 21 with heart disease.In the control group,33 cases were matched with the general condition of the case group(P<0.05,the difference was not statistically significant).2.2 The serum levels of 8-iso-PGF2? in case group and control group: The level of serum 8-iso-PGF2? in acute ischemic stroke patients was higher than that in control group.The difference was statistically significant(P<0.05).2.3 The general data of PSD group and NPSD group: There was no significant difference in age,gender,cerebrovascular risk factors(hypertension,heart disease,diabetes,smoking,drinking history)between PSD group and NPSD group.(P>0.05).2.4 The serum levels of 8-iso-PGF2? in control group,PSD group and NPSD group: PSD group serum 8-iso-PGF2? level was higher than NPSD group and control group,the difference was statistically significant(P<0.05);There was no significant difference in serum 8-iso-PGF2? between the group and the non-PSD group(P>0.05).2.5 The scores of NIHSS in NPSD group,mild PSD group and moderate-severe PSD group: The average score of NIHSS in mild PSD group and moderate-severe PSD group was higher than NPSD group;and the difference was statistically significant(P<0.05).The average score of NIHSS of the moderate-severe PSD group was higher than that of the mild PSD group;the difference was statistically significant(P<0.05).3 The correlation analysis between the levels of serum 8-iso-PGF2? and HAMD scores in PSD group: HAMD scores of PSD patients were positively correlated with the concentration of serum 8-iso-PGF2?(P< 0.001).4 Predictive effect of the concentration of serum 8-iso-PGF2? and NIHSS scores on PSD in acute ischemic stroke: the predictive value of the concentration of serum 8-iso-PGF2?(AUC = 0.630,95% CI 0.540-0.721,P=0.009)was not as good as that of NIHSS scores(AUC = 0.742,95% CI 0.661-0.823,P<0.001).The predicted cutoff value of the NIHSS score is 4 points(sensitivity 0.604,specificity 0.722).Conclusion:1.The incidence of PSD in the acute phase of acute ischemic stroke was 37.1%;2.Oxidative stress plays an important role in the occurrence of PSD;3.8-iso-PGF2? may play an important role in the development of PSD;4.The value of early level of serum 8-iso-PGF2? that predicts the depression after acute ischemic stroke is low. |
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