Clinical Significance Of SSR Combined With TNF-α Detection In Early Diagnosis Of Post-stroke Depression

Objective:To investigate the clinical significance of Skin sympathetic response(SSR)and plasma TNF-a levels in patients with acute stroke in the early diagnosis of post-stroke depression(PSD).Methods:46 patients with acute ischemic stroke were divided into simple stroke group(S group)and post-stroke depression group(PSD group)by HAMD score;23 healthy people were selected as control group(N group).The severity of stroke was assessed according to the National Institutes of Health Stroke Scale(NIHSS).Three groups of subjects were tested for sympathetic skin reaction(SSR)and three groups of venous blood plasma TNF-a were detected using the Keypoint electromyograph from Medtronic,USA.Compared that there was or not had correlation between the HAMD score,NIHSS score,SSR and plasma TNF-a in the three groups.Results:1.Compared with the normal group and the simple stroke group,the post-stroke depression group had longer SSR latent period and lower amplitude of the upper and lower limbs,and the difference was statistically significant(P<0.001);Compared with the normal control group,the SSR latency delay and amplitude reduced of the upper and lower limbs in the simple stroke group,and the difference was statistically significant(P<0.001);Compared with moderate depression group,the severely depressed group’s SSR latency of the upper and lower limbs was delayed and the amplitude was decreased.The difference was statistically significant(P<0.05).2.The HAMD score of the post-stroke depression group was higher than that of the normal group and the simple stroke group.The difference was statistically significant(P<0.001);The NIHSS score in the post-stroke depression group was significantly higher than that in the simple stroke group.The difference was statistically significant(P<0.001);The NIHSS score was positively correlated with the HAMD score in the post-stroke depression group.There was no correlation between NIHSS score and HAMD score in the simple stroke group;The NIHSS score in the severe depression group was significantly higher than moderate depression group,and the difference was statistically significant(P<0.01).3.The SSR latency of the upper and lower limbs of the post-stroke depression group was positively correlated with the HAMD score,and the amplitude was negatively correlated with the HAMD score;In simple stroke group,The SSR latency of the upper limb was positively correlated with the HAMD score,and the lower limb amplitude was negatively correlated with the HAMD score.In control group,there is no correlation between SSR latency,amplitude and HAMD score o fthe upper and lower limbs.4.The SSR latency of the upper and lower limbs of the post-stroke depression group was positively correlated with the NIHSS score,and the amplitude was negatively correlated with the NIHSS score.the SSR latency and the amplitude of the upper and lower limbs of the simple stroke group had no correlated with the NIHSS score.5.The plasma levels of TNF-α in the post-stroke depression group and the simple stroke group were significantly higher than those in the normal group.The difference was statistically significant(P<0.05).The plasma levels of TNF-α in the post-stroke depression group were significantly higher than those in the normal group,and the difference was statistically significant(P<0.001).The plasma TNF-α level in the severe depression group was significantly higher than moderate depression group,and the difference was statistically significant(P<0.001).6.The plasma TNF-α level in the post-stroke depression group was positively correlated with the SSR latency of the upper and lower limbs,and the amplitude was negatively correlated.The plasma TNF-α levels in the stroke group and the healthy group were not correlated with the SSR latency and amplitude of the upper and lower limbs.The plasma TNF-α level in the post-stroke depression group was positively correlated with the HAMD score and NIHSS score.The plasma TNF-α levels in the stroke group and the normal group were not correlated with the HAMD score.The plasma TNF-α level and NIHSS score in the stroke-group had no correlation.Conclusion:1.Post-stroke depression patients with NIHSS,HAMD scores combined with SSR latency,amplitude and abnormal changes in plasma TNF-α levels can be used to determine post-stroke depression and assess its severity.2.Combined detection of SSR and TNF-α levels by NIHSS and HAMD scores can provide a scientific basis for early diagnosis and assessment of post-stroke depression.