Low Serum Levels of Uric Acid are Associated With Development of Poststroke Depression.

Low Serum Levels of Uric Acid are Associated With Development of Poststroke Depression.
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DOI:
10.1097/md.0000000000001897
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发表时间:
2015-11
期刊:
影响因子:
1.6
通讯作者:
He J
He J
中科院分区:
医学4区
文献类型:
--
作者:
Gu Y;Han B;Wang L;Chang Y;Zhu L;Ren W;Yan M;Zhang X;He J

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卒中后抑郁(PSD)是一种常见的卒中并发症,与卒中患者预后不良有关。这项研究试图研究血清尿酸水平与PSD发生之间的可能联系。我们招募了196名急性缺血性中风患者和100名健康志愿者。入院后24 内用尿酸酶-PAP法检测血尿酸水平。在卒中后3个月进行神经心理评估。采用17项汉密尔顿抑郁量表评定抑郁症状。PSD的诊断符合DSM-IV抑郁症诊断标准。采用Logistic回归模型进行多因素分析。56例患者(28.6%)在3个月时被诊断为PSD。PSD患者基础尿酸水平显著低于非PSD患者(237.02 ± 43.43vs 309.10 ± 67.44moL/L,t = −8.86,P < 0.001)。在多因素分析中,尿酸水平(≤239.0和≥328.1 μ/L)与抑郁的发生独立相关(OR7.76;95%可信区间[CI]分别为2.56~23.47,P < 0.001和OR,0.05;95%CI,0.01~0.43,P = 0.01)。入院时的血尿酸水平被发现与PSD相关,并可在中风后3个月预测其发展。
Poststroke depression (PSD) is a frequent complication of stroke that has been associated with poorer outcome of stroke patients. This study sought to examine the possible association between serum uric acid levels and the development of PSD. We recruited 196 patients with acute ischemic stroke and 100 healthy volunteers. Serum uric acid levels were tested by uricase-PAP method within 24 hr after admission. Neuropsychological evaluations were conducted at 3-month poststroke. The 17-item Hamilton Depression Scale was used to assess depressive symptoms. Diagnosis of PSD was made in accordance with DSM-IV criteria for depression. Multivariate analyses were conducted using logistic regression models. Fifty-six patients (28.6%) were diagnosed as having PSD at 3 months. PSD patients showed significantly lower levels of uric acid at baseline as compared to non-PSD patients (237.02 ± 43.43 vs 309.10 ± 67.44 μmol/L, t = −8.86, P < 0.001). In multivariate analyses, uric acid levels (≤239.0 and ≥328.1 μmol/L) were independently associated with the development of PSD (OR, 7.76; 95% confidence interval [CI], 2.56–23.47, P < 0.001 and OR, 0.05; 95% CI, 0.01–0.43, P = 0.01, respectively) after adjustment for possible variables. Serum uric acid levels at admission are found to be correlated with PSD and may predict its development at 3 months after stroke.