血小板相关指标与急性缺血性卒中后抑郁的相关性研究

目的分析血小板相关指标与急性缺血性卒中后抑郁( post-stroke depression，PSD)的关系。方法选取 2021年 9月至 2022年 5月在华北理工大学附属唐山市工人医院治疗的急性缺血性卒中病人 235例，记录其一般临床资料，根据 17项汉密顿抑郁量表(Hamilton depression rating scale，17 item，HAMD-17)评分将病人分为 PSD组和非 PSD组；测定各组病人血小板相关指标(血小板计数、血小板平均体积、血小板比容、血小板分布宽度)；使用美国国立卫生院卒中量表( national institute of health stroke scale，NIHSS)、日常生活活动能力量表( activity of daily living，ADL)分别评估病人神经功能缺损情况和日常生活能力；采用多因素二元 logistic回归模型分析与 PSD相关的独立危险因素。结果研究共纳入缺血性脑卒中病人 235例， PSD组病人 85例，非 PSD组病人 150例。 PSD组身体质量指数、 NIHSS评分高于非 PSD组， PSD组 ADL评分低于非 PSD组( P<0.05)。两组血小板计数和平均血小板体积分级分布上均差异有统计学差意义(P<0.05)； PSD组血小板计数 ≤183×109/L、(>183~<257)×109/L、 ≥257×109/L分别有 11例( 12.9%)、 47例( 55.3%)、 27例( 31.8%)，非 PSD组分别有 47例( 31.3%)、 72例( 48.0%)、 31例( 20.7%)。多因素二元 logistic回归分析结果显示，较高水平血小板计数、身体质量指数及 NIHSS评分是 PSD的独立危险因素( P<0.05)。结论较高水平的血小板计数是 PSD发生的独立危险因素。

Correlation between platelet related indexes and depression after acute ischemic stroke

Objective To analyse the relationship between platelet-related indicators and post-stroke depression (PSD) after acute ischaemic stroke.Methods A total of 235 patients with acute ischemic stroke, admitted to Tangshan People''s Hospital Affiliated toNorth China University of Science and Technology from September 2021 to May 2022, were included in the study, and their general clinical data were recorded. Patients were assigned into PSD and non-PSD groups according to the 17-item Hamilton Depression Rating Scale ( HAMD-17) scores. Platelet-related indicators (platelet count, mean platelet volume, platelet volume, platelet distribution width)were measured in each group. The National Institute of Health Stroke Scale (NIHSS) and the Activity of Daily Living (ADL) were used toassess the neurological deficits and patients'' ability and to perform activities of daily living, respectively. The independent risk factorsassociated with PSD were analysed using multifactorial Logistic regression models. Results A total of 235 patients with ischaemic stroke were included in the study, 85 patients in the PSD group and 150 patients in the non-PSD group. The results of comparing thebaseline characteristics of the two groups showed that the body mass index and NIHSS scores were higher in the PSD group than in thenon-PSD group, and the ADL scores were lower in the PSD group than in the non-PSD group (P<0.05). The platelet-related indexes of the two groups were assigned into three levels using P25 and P75 as the boundaries, and the results showed that there were statistical differences in the distribution of platelet count and mean platelet volume between the two groups (P<0.05). Among the 85 patients with PSD, 11 (12.9%) had the platelet count ≤183×109/L, 47 (55.3%) had platelet counts between (>183 and <257) ×109/L, and 27 (31.8%) had platelet count ≥257 ×109/L,and among the 150 non-PSD patients, there were 47 (31.3%), 72 (48.0%) and 31 (20.7%) respectively. Multi-factorial Logistic regression analysis results showed that higher levels of platelet count, body mass index and NIHSS score were independent risk factors for PSD (P<0.05).Conclusion Higher level of platelet count is an independent risk factor for the development of PSD.