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脑卒中后抑郁患者交感神经皮肤反应与血浆多巴胺、5-羟色胺及HAMD评分的相关性分析
引用本文:郦铮铮,丛文杰,郑晓露,张楠.脑卒中后抑郁患者交感神经皮肤反应与血浆多巴胺、5-羟色胺及HAMD评分的相关性分析[J].中华全科医学,2019,17(3):384-387.
作者姓名:郦铮铮  丛文杰  郑晓露  张楠
作者单位:温州医科大学附属第一医院神经内科, 浙江 温州 325000
基金项目:浙江省自然科学基金项目(LQ18H09007)
摘    要:目的 探讨脑卒中后抑郁患者交感神经皮肤反应(SSR)与血浆多巴胺(DA)、5-羟色胺(5-HT)及汉密顿抑郁量表(HAMD)评分的相关性。 方法 选取2016年5月-2018年5月温州医科大学附属第一医院脑卒中后抑郁患者57例、脑卒中无抑郁患者55例,体检健康者50例作为研究对象,检测并比较各组上肢正中神经、下肢胫后神经SSR潜伏期与波幅、血浆DA、5-HT水平以及HAMD评分,以及分析它们之间的相关性。 结果 脑卒中后抑郁组患者的上、下肢SSR潜伏期、波幅均显著高于正常对照组(均P<0.05),上、下肢SSR潜伏期均显著高于脑卒中后无抑郁组(均P<0.05);脑卒中后无抑郁组患者的上肢SSR潜伏期显著高于正常对照组(P<0.05),上、下肢SSR波幅均显著低于正常对照组(均P<0.05)。脑卒中后抑郁组血浆DA、5-HT水平显著低于脑卒中无抑郁组与正常对照组(均P<0.05)。脑卒中后抑郁组HAMD评分与上、下肢SSR潜伏期呈正相关(均P<0.05),与DA、5-HT呈负相关(均P<0.05)。脑卒中后抑郁组上、下肢SSR潜伏期与血浆DA、5-HT水平呈负相关(均P<0.05);正常对照组上肢SSR潜伏期与血浆DA、5-HT水平呈负相关(均P<0.05),下肢SSR潜伏期与血浆DA呈负相关(P<0.05)。 结论 对SSR、血浆DA、5-HTshui进行检测并将其和HAMD评分有机结合起来能够更为严谨、准确地判断脑卒中后抑郁患者,将可靠的诊断依据提供给临床。 

关 键 词:脑卒中后抑郁    交感神经皮肤反应    多巴胺    5-羟色胺
收稿时间:2018-09-12

Correlation between sympathetic skin response and plasma dopamine,serotonin and HAMD scores in patients with post-stroke depression
Institution:Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
Abstract:Objective To investigate the correlation between sympathetic skin response (SSR) and plasma dopamine (DA), serotonin (5-HT) and Hamilton Depression Scale (HAMD) scores in patients with post-stroke depression. Methods A total of 57 patients with post-stroke depression and 55 patients with stroke-free depression were enrolled from May 2016 to May 2018 in our hospital. Fifty health people were included in the study. The SSR latency and amplitude of plasma in the medial and lower extremity of the lower extremities were measured and compared. 5-HT levels as well as HAMD scores, and analysis of the correlation between them. Results The SSR latency and amplitude of upper and lower limbs in the post-stroke depression group were significantly higher than those in the normal control group (all P<0.05), and the SSR latency of upper and lower limbs in the post-stroke depression group was significantly higher than that in the post-stroke non-depression group (all P<0.05). The SSR latency of upper limbs in the non-depressive group after stroke was significantly higher than that of the normal control group (P<0.05), and the SSR amplitude of upper limbs and lower limbs was significantly lower than that of the normal control group (all P<0.05). The levels of plasma DA and 5-HT in the post-stroke depression group were significantly lower than those in the non-depression group and the normal control group (all P<0.05). The HAMD scores and SSR latency of the upper and lower limbs in the post-stroke depression group were positively correlated (all P<0.05), and were not correlated with the amplitude, but negatively correlated with DA and 5-HT (all P<0.05). The stroke-free group and the normal control group.The SSR latency of upper and lower limbs in the post-stroke depression group was negatively correlated with plasma DA and 5-HT levels (all P<0.05). The SSR latency of upper limbs in the normal control group was negatively correlated with plasma DA and 5-HT levels (all P<0.05). The SSR latency of lower limbs was negatively correlated with plasma DA (P<0.05). Conclusion Based on the detection of SSR, combined with plasma DA, 5-HT level and HAMD score, it can make more rigorous and accurate judgment on patients with post-stroke depression, and can provide a reliable diagnosis basis for clinical. 
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