脑卒中后抑郁症血浆皮质醇节律的临床研究

目的：探讨脑卒中后抑郁症（psot stroke depression,PSD）患者血浆皮质醇含量的变化。方法：对74例脑卒中患者在发病3周内进行流调中心用抑郁自评量表（CES-D）自评,根据其评分将患者分为卒中后抑郁组和卒中后非抑郁组 同时分别于清晨8时（8 am）、下午4时（4 pm）、夜间12时（12 mn）取静脉血进行血浆皮质醇含量测定。选择同时期我院核医学科血浆皮质醇节律检查正常的30例患者作为对照组。所得数据用SPSS 13.0软件包进行统计学处理。结果：卒中后抑郁组、卒中后非抑郁组和对照组,血浆皮质醇含量均随时间不同而不同,其变化具有节律性（P〈0.01） 在3个时间点上,卒中后抑郁组、卒中后非抑郁组的血浆皮质醇含量均较对照组升高（P〈0.05） 但卒中后抑郁组、非抑郁组之间比较,血浆皮质醇含量差异无统计学意义（P〉0.05）。在每组内部3个时间点分别比较,卒中后抑郁组8 am分别与4 pm和12 mn比较,卒中后非抑郁组和对照组在84、pm和12 mn之间分别两两比较,差异均有统计学意义（P〈0.05） 卒中后抑郁组4 pm与12 mn比较差异无统计学意义（P〉0.05）。结论：脑卒中后血浆皮质醇含量较正常升高 卒中后抑郁患者不仅表现为血浆皮质醇含量升高,还表现为血浆皮质醇节律紊乱,具体为4 pm与12 mn失去正常的节律性变化。

Clinical Study of Blood Plasma Corticosteroid Rhythm in Post Stroke Depression

Objective：To investigate the change of blood plasma corticosteroid rhythm with post stroke depression in the patients of stroke.Methods： We investigated 74 patients who had the first-time stroke within 3 weeks.The patients underwent the CES-D and the mensuration of the blood plasma corticosteroid at 8 am、4 pm and 12 mn within 3 weeks after the stroke.According to the score of the CES-D,these patients were devidided into two groups：post stroke depression and post stroke non-depression 30 healthy volunteers were selected because of their normal results of the blood plasma corticosteroid checked in the department of nuclear medicine in our hospital at same period.The datas were analyzed with SPSS 13.0.Results：The contents of blood plasma corticosteroid in all stroke patients and healthy volunteers were different along with the time＇s diversity（P0.01）.At the same time point,the contents of blood plasma corticosteroid in all stroke patients were higher than that of the healthy volunteers（P0.05）,but there were no difference between the post stroke depression and the post stroke non-depression（P0.05）.There was significant difference among the three time points in poststroke nondepression group and normal group（P0.05） There was no difference between 4 pm and 12 mn in the post stroke depression group（P0.05）.Conclusion： The contents of blood plasma corticosteroid in the patients of stroke were higher than that of the normal group.The contents of blood plasma corticosteroid in post stroke depression shows not only rise but also rhythm disturbance,they lost the normal rhythm change at 4 pm and 12 mn.