血清25羟基维生素D水平与老年人卒中后抑郁的相关性

摘要

Objective To investigate the correlation between serum 25 hydroxyvitamin D[25 (OH) D] level and post-stroke depression in elderly patients with acute stroke.Methods Depression was assessed by Beck Depression Inventory (BDI),Burns Depression Checklist (BDC),and the Diagnostic and Statistical Manual of Mental Disorders Ⅳ in 231 elderly inpatients at 2-4 weeks after onset of acute cerebral infarction.According to the depression assessment,the patients were classified into four groups:normal group),depressive symptoms group,with mild depression group,and severe depression group.The cut-off point of 25 (OH) D level for post stroke depression was analyzed by receiver operating characteristic (ROC).Results The serum level of 25(OH)D was (23.0±1.6) nmol/L in all subjects,(25.0±1.7) nmol/L in normal group,(23.7± 1.6) nmol/L in depressive symptoms group,(22.4±1.5) nmol/L in mild depression group,(16.3± 1.5) nmol/L in severe depression group.Serum 25(OH) D level had significant differences between major depression groups and other three groups,while no significant differences were found between mild depression group,depressive symptoms group and normal group.Pearson correlation analysis showed that scores of BDI and BDC were inversely related to 25 (OH)D level (r=0.24 and-0.25,both P＜0.01).ROC curve analysis showed that the cut off point of serum 25 (OH) D level for severe post-stroke depression was 21.6 nmol/L.Conclusions Serum 25 (OH)D level is inversely related to depression.Serum 25(OH) D level is reduced in patients with severe post stroke depression.%目的 探讨急性卒中患者血清中25羟基维生素D [25(OH)D]水平与卒中后抑郁的相关性. 方法 对231例老年急性脑梗死后2～4周的患者进行抑郁的测量,采用的测量工具为精神疾病诊断与统计手册(DSM)-Ⅳ、贝克抑郁量表及伯恩斯抑郁量表.根据测量结果分为无抑郁组、抑郁症状组、轻度抑郁障碍组及重性抑郁组.采用受试者工作特征(ROC)曲线分析确定脑卒中重性抑郁患者的25(OH)D浓度的临界值. 结果 入选患者血清25(OH)D浓度为(23.0±1.6)nmol/L,无抑郁组为(25.0±1.7) nmol/L,抑郁症状组为(23.7±1.6) nmol/L,轻度抑郁障碍组为(22.4±1.5)nmol/L,重性抑郁组为(16.3±1.5) nmol/L,重度抑郁组与轻度抑郁障碍组、抑郁症状和无抑郁组差异有统计学意义,轻度抑郁症组、抑郁症状组和无抑郁组间差异无统计学意义.皮尔森相关分析结果显示,贝克量表与伯恩斯量表的分数与25(OH)D水平呈负相关(r值分别为-0.24、-0.25,均P＜0.01);ROC分析提示脑卒中重性抑郁25(OH)D临界值为21.6 nmol/L. 结论 血清25(OH)D浓度与脑卒后抑郁程度呈负相关.重性抑郁患者的血清25(OH)D浓度降低.