Prediction Of Depression In Patients With Acute Stroke By PCT、 IL-6 And CRP

Objective:To explore the depression situation of acute stroke patients 1 month after stroke,and to explore the predictive value of PCT,CRP and IL-6 in stroke and post-stroke depression,so as to provide reference for early detection of depression in patients with acute stroke and timely intervention.Methods:Patients with acute stroke who were first admitted to the Department of Neurology of the First Affiliated Hospital of Dali University from January 2021 to January 2022 were selected and each patient after admission was questioned by ph Q-9 scale.159 patients with stroke who had depression before stroke were excluded and included in the study group.General data of the patients were collected and the indicators of PCT,CRP,IL-6,HCY and TG in fasting serum were detected within 24 hours.The patients were reviewed in outpatient department 1 month after stroke and consulted in person.Depression was assessed by clinical symptomatology combined with HAMD-24 rating scale.Finally,according to the scoring results,the patients were divided into poststroke depression group（PSD group）and poststroke non-depression group（non-PSD group）.PSD group was divided into mild PSD group,moderate PSD group and severe PSD group according to the score.A total of 150 patients with non-stroke and non-infection were selected as the control group.Results: 1.The differences of general data,PCT,CRP,IL-6,HCY and TG between the stroke group and the control group were compared.2.By comparing the general data,NIHSS score and laboratory indicators of PSD group and non-PSD group,the correlation between PSD group and THE occurrence of PSD was analyzed;Further analysis of general data,NIHSS score and laboratory indicators in different degree of depression group whether there were statistical differences;3.Calculate the areas of PCT,CRP,IL-6,HCY and NIHSS scores under the ROC curve of PSD,and judge their predictive value to the occurrence of PSD.4.Spearman correlation was used to analyze the correlation between depression score and various variables.Logistic regression was used to analyze the risk factors of recurrent depression in stroke patients.0.05 was considered statistically significant.Results:1.Among 159 stroke patients collected,60 patients were diagnosed with PSD after1 month,with an incidence of 37.74%.Mainly mild to moderate depression.2.In general data,only hypertension and heart disease history of the stroke group and the control group had statistical significance（P < 0.05）.Compared with the control group,serum CRP,HCY,PCT and IL-6 were increased in the stroke group,while serum TG was decreased,with statistically significant differences（P < 0.05）.3.ROC curve analysis showed that IL-6 had the best diagnostic value for stroke,with the highest AUC of 0.73,Yuden index of 0.42,sensitivity of 63.5% and specificity of 78.0%.HCY and PCT were the next.Residual indexes were also of diagnostic significance.4.There were statistically significant differences in age,smoking history and diabetes history between PSD group and non-PSD group（P < 0.05）;There were no significant differences in gender,alcohol consumption,stroke type,stroke location,hypertension and heart history（P > 0.05）,as shown in Table 4.The NIHSS score,serum CRP,HCY,PCT and IL-6 of the PSD group were higher than those of the non-PSD group,with statistically significant differences（P < 0.05）,while there was no statistically significant difference in TG（P > 0.05）。5.ROC curve analysis showed that PCT had the best diagnostic value for PSD,with the highest AUC of 0.86,Yuden index of 0.62,the highest diagnostic sensitivity of83.3%,and the highest specificity of 78.8%.Il-6 and CRP were second,and the other indicators were also of diagnostic significance.6.There was no statistical significance in the comparison of general data of depression degree among the three groups（ALL P > 0.05）.There were no significant differences in serum TG,NIHSS,HCY and IL-6 among the three groups with different levels of depression（ALL P > 0.05）.Serum CRP and PCT in mild PSD group were lower than those in moderate and severe PSD groups,and the differences were statistically significant（P < 0.05）.Serum CRP and PCT in moderate PSD group were lower than those in severe PSD group,and the differences were statistically significant（P < 0.05）,.7.Spearman correlation analysis showed that PSD and CRP（R =0.33,P<0.001）,IL-6（r=0.30,P<0.001）,PCT（r=0.27,P<0.001）,NIHSS score（r=0.16,P<0.001）positive correlation;Was not correlated with HCY（r=0.01,P=0.464）.8.Logistic regression analysis was conducted on the relevant factors that were significant in the diagnosis of PSD patients: Univariate Logistic regression analysis showed that age,smoking,diabetes,NIHSS score,CRP,PCT and IL-6 levels were independent risk factors for PSD.Multivariate Logistic regression analysis showed that smoking,diabetes and PCT were independent risk factors for PSD.Conclusions:1.The incidence of poststroke depression in acute stroke patients within 1 month after stroke was 37.74%,mainly mild and moderate depression.2.The NIHSS score,serum CRP,HCY,PCT and IL-6 in PSD group were significantly higher than those in non-PSD group,and the occurrence of PSD was positively correlated with NIHSS score,serum CRP,PCT and IL-6.3.Serum PCT,CRP,IL-6,NIHSS score,smoking,diabetes and age mellitus were independent risk factors for PSD.Compared with serum CRP,IL-6 and NIHSS scores,serum PCT had better predictive value,higher diagnostic sensitivity and specificity for PSD.And the higher the PCT,the higher the depression degree.