血孤啡肽与脑梗死病情进展及脑梗死后抑郁的相关性

摘要

Objective To investigate the correlation between serum orphanin FQ with cerebral infarction and post-stroke depression.Methods The peripheral venous blood samples of one hundred and ninety-five patients with cerebral infarction were collected at different time points after the onset.The levels of orphanin in the serum were measured.According to the progress of disease,the patients were divided into the progress group and non-progress group;according to the mental status,the patients were divided into depression and non-depression group.The relationship between HAMD score and limbus orphanin levels was an-alyzed.The location of cerebral infarction and damage of serotonergic neurons in patients were observed by imaging method.The blood orphanin levels in patients with or without impaired serotonergic neurons were compared.Results The level of orphanin in patients with cerebral infarction was not significantly different from that in the healthy population (P >0.05).The level of orpha-nin was gradually higher than that of the healthy group after 24 hours of onset (P <0.05 ).Both progress group and depression group showed significantly higher orphanin level than that of the non-progress group and non-depression group,respectively,and the HAMD score was positively correlated with the levels of orphanin FQ in the depression group.Patients with impaired seroton-ergic neurons had significantly higher ornithine level and higher proportion of depression than that of non-impaired group (P <0.05).Conclusion The upregulation of serum orphanin level can promote the progression and the occurrence of depression after cerebral infarction.%目的 分析血孤啡肽与脑梗死患者病情进展及脑梗死后抑郁的相关性.方法 选取195例脑梗死患者,分别于发病后不同时间点采集静脉血,检测血孤啡肽水平.根据脑梗死后病情是否进展分为进展组和非进展组,比较2组血孤啡肽水平,根据脑梗死后是否发生抑郁分为抑郁组和非抑郁组,比较2组血孤啡肽水平,并分析HAMD评分与血孤啡肽的相关性,通过影像学明确脑梗死部位、5-羟色胺能神经元是否发生损伤.比较不同梗死部位、5-羟色胺能神经元是否发生损伤患者的血孤啡肽水平.结果 脑梗死患者发病后24 h内的血孤啡肽水平与健康人群比较无明显差异(P>0.05),发病时间>24 h后血孤啡肽水平逐渐高于健康人群;进展组血孤啡肽水平高于非进展组(P<0.05);抑郁组血孤啡肽水平高于非抑郁组(P<0.05),且抑郁组HAMD评分越高,血孤啡肽水平越高;多梗死病灶患者的血孤啡肽水平最高,其次为皮层下梗死患者;5-羟色胺能神经元损伤患者的血孤啡肽水平高于5-羟色胺能神经元未损伤的患者(P<0.05);5-羟色胺能神经元损伤患者中发生抑郁所占比例明显高于未发生抑郁患者(P<0.05).结论 血孤啡肽水平升高对脑梗死患者病情进展和脑梗死后抑郁的发生具有促进作用.