The Study On The Relationship Between Homocysteine Level And Depression In Patients With Cerebral Microbleeds

Objective:Homocysteine is a risk factor for eerebrovascular disease and cerebral microbleeds is one of the main manifestations of cerebral vacular disease,which is closely related to cognitive function and affective disorder,in this paper,we measured the level of homocysteine in patients with cerebral microbleeds to analyze the relationship between homocysteine level and affective disorder(depression)in patients with cerebral microbleeds.Methods:From January 2017 to November 2018,collected 60 inpatients with cerebral microbleeds which were diagnosed by magnetic resonance magnetic sensitivity examination in the Department of Neurology and Cerebrovascular Disease,the second affiliated Hospital of Kunming Medical University.According to the diagnostie criteria of depression without psychotic symptoms in the Manual of diagnosis and Statistics of Mental Disorders(4th Edition)(DSM-IV),60 patients with cerebral microbleeds were divided into depression group(n=22)and non-depression group(n=38).To analyze all the patients clinical date(age,sex,drinking history,smoking history)and past history(stroke history,hypertension,diabetes mellitus,hyperlipidemia).All the subjects were examined by MRI+SWI,the total number of lesions and the number of lesions in each part of cerebral microhbleeds were recorded The severity of cerebral microbleeds was graded according to the number of cerebral microbleeds:Mild(1-2),moderate(3-10),severe(>10),The sites of cerebral microhemorrhage are classification to lobe CMBs(frontal lobe,temporal lobe,pari lobe,occipital lobe and insular lobe),deep CMBs(basal ganglia,thalamus.internal/external capsule,corpus callosum and periventricular)and subtentorial CMBs(brainstem and cerebellum).All subjects were evaluated with Hamilton Depression scale(HAMD),and the degree of depression was graded according to the score:mild depression(7?16 points),moderate depression(17?24 points)and severe depression(>24 points).Fasting venous blood was collected on the second day after admission to the laboratory of Kunming Medical University to detect the level of serum homocysteine and related biochemical indicators.SPSS 22.0 statistical software was used to analyze the data,in which the measurement data of normal distribution were expressed by mean soil standard deviation(x±s),and the measurement data of non-normal distribution were expressed by Median(25th percentile-75th percentile)(M(Q25-Q75)).Two independent sample t tests were used to analyze the data of normal distribution,and nonparanetric test(Mann-Whitney U test)was used to compare the data of non-normal distribution.The counting data were analyzed by completely random design four-grid table chi-square test(X2 test),the univariate correlation analysis was analyzed by Spearman eorrelation analysis,and the risk factor analysis was analyzed by Binary logistic regression analysis.The selection and exclusion values of variables were 0.05,P<0.05.There was significant difference between the two groups(P<0.05).Results:The incidence of depression was 36.7%in CMBs patients,63.6%in mild depression group,27.3%in moderate depression group and 9.1%in severe depression group.In the general analysis of depression group and non-depression group,sex,age,smoking history and drinking were found some difference,but there were no statistical significance(P>0.05).The proportion of stroke,diabetes and hyperlipidemia in depression group was higher than that in non-depression group,but the difference was not statistically significant(P>0.05).The proportion of hypertension in depression group was lower than that in non-depression group,the difference was not statistically significant(P>0.05).The average Hey level in depression group was 23.90±10.00umol/L,which was significantly higher than that in non-depression group(14.92±3.43umol/L).There was significant difference in Hcy between the two groups(P=0.000<0.05).There was a linear trend between HAMD-17 score and serum Hcy level,and the correlation coefficient of Spearman was rs=0.267,P=0.248>0.05.which was not statistically significant.There was significant difference in the total number of CMBs between the two groups(P=0.000<0.05).The correlation analysis between HAMD-17 score and the total number of CMBs showed that the rank correlation coefficient of Spearman was rs=0.506,P=0.016<0.05,it was statistically significant.There was significant difference in the number of lesions in all parts of CMBs in depression group and non-depression group(P<0.05).Binary logistic regression analysis of the possible risk factors of CMBs with depression showed that elevated Hey levels(X2=110.148,P=0.001)and multiple CMBs(X2=8.895,P=0.003)were independent risk factors for depression in CMBs.The incidence of depression in CMBs patients with Hcy?23.90umol/L was 1.216 times higher than that in patients with Hcy<23.90umol/L,and the total number of CMBs was higher.The incidence of depression in patients with CMBs?10 was 1.171 times higher than that in patients with CMBs<10.Conclusions:1.High serum Hcy level and multiple lesions of CMBs may be independent risk factors of CMBs with depression;2.In CMBs patients with depression,the number of CMBs lesions is positively correlated with the severity of depression.