文章摘要
血浆致动脉硬化指数同型半胱氨酸联合脑小血管病总体负荷在脑卒中后抑郁中的预测意义
The predictive significance of plasma atherogenic index, homocysteine, and overall burden of cerebral small vessel disease in post-stroke depression
投稿时间：2025-10-08  
DOI：10.3969/j.issn.1000-0399.2026.09.005
中文关键词: 脑卒中  抑郁  血浆致动脉硬化指数  同型半胱氨酸  磁共振成像  脑小血管病总体负荷
英文关键词: Stroke  Depression  Atherogenic index of plasma  Homocysteine  Magnetic resonance imaging  Overall burden of cerebral small vessel disease
基金项目:河北省医学科学研究重点课题计划项目(编号:20241031);承德市科技计划项目(编号:202402A044)
作者单位E-mail
李岩 067000 河北承德 中国人民解放军联勤保障部队第981医院神经内科  
周搏 067000 河北承德 中国人民解放军联勤保障部队第981医院神经内科  
杨晓凤 067000 河北承德 中国人民解放军联勤保障部队第981医院神经内科  
李灵玲 067000 河北承德 中国人民解放军联勤保障部队第981医院神经内科  
乔可心 067000 河北承德 中国人民解放军联勤保障部队第981医院神经内科  
郭艳玲 067000 河北承德 中国人民解放军联勤保障部队第981医院传染科 meigaomeimei9860@163.com 
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中文摘要:
      目的 探讨血浆致动脉硬化指数（AIP）与同型半胱氨酸（Hcy）联合脑小血管病（CSVD）总体负荷对脑卒中后抑郁（PSD）的预测价值。方法 回顾性分析中国人民解放军联勤保障部队第981医院2022年1月至2024年10月收治的108例脑卒中患者资料，根据是否发生PSD分为PSD组[35例，汉密尔顿抑郁量表（HAMD-24）≥20分]与非PSD组（73例，HAMD-24评分<20分）。比较两组基线资料、AIP、Hcy水平、CSVD总体负荷评分、HAMD-24评分，分析AIP、Hcy、CSVD总体负荷评分与HAMD-24评分的相关性及对PSD的影响，评价AIP、Hcy水平、CSVD总体负荷评分单独及联合对PSD的预测价值。结果 PSD组高脂血症比例、美国国立卫生研究院卒中量表（NIHSS）评分、总胆固醇（TC）、三酰甘油（TG）高于非PSD组，蒙特利尔认知评估量表（MoCA）评分、高密度脂蛋白胆固醇（HDL-C）低于非PSD组（P<0.05）;PSD组AIP、Hcy水平、CSVD总体负荷评分、HAMD-24评分高于非PSD组（P<0.05）;Pearson相关性分析结果显示，AIP、Hcy、CSVD总体负荷评分与HAMD-24评分呈正相关（P<0.05）;logistic回归分析结果显示，AIP、Hcy、CSVD总体负荷评分是PSD的独立影响因素（P<0.05）;AIP、Hcy、CSVD总体负荷评分联合预测PSD的曲线下面积（AUC）为0.916，较单一指标的AUC(0.732、0.756、0.778)提升（Z=3.564、2.550、2.357,P=0.001、0.011、0.018）。结论 AIP、Hcy、CSVD总体负荷评分是PSD的独立影响因素，3者联合检测对这类患者的预测价值较高，能帮助临床及时采取针对性防治措施。
英文摘要:
      Objective To explore the predictive significance of the combination of the atherogenic index of plasma(AIP), homocysteine(Hcy), and the overall burden of cerebral small vessel disease(CSVD) for post-stroke depression(PSD). Methods The data of 108 stroke patients admitted to the 981 st Hospital of China People's Liberation Army Joint Logistics Support Force from January 2022 to October 2024 were retrospectively analyzed. According to the occurrence of PSD, they were divided into the PSD group [35 cases, Hamilton Depression Scale(HAMD-24) ≥ 20 points] and the non-PSD group(73 cases, HAMD-24 < 20 points). The baseline data, AIP, Hcy levels, CSVD overall burden score, and HAMD-24 score were compared between the two groups. The correlation between AIP, Hcy, CSVD overall burden score, and HAMD-24 score and their influence on PSD were analyzed. The individual and combined predictive values of AIP, Hcy levels, and CSVD overall burden score for PSD were evaluated. Results The proportion of hyperlipidemia, NIHSS score, and the levels of total cholesterol(TC) and triglyceride(TG) in the PSD group were higher than those in the non-PSD group, and the MoCA score and HDL-C levels were lower than those in the non-PSD group(P<0.05). The PSD group also had higher AIP, Hcy levels, CSVD overall burden score, and HAMD-24 score than the non-PSD group(P<0.05). Pearson correlation analysis showed a positive correlation between AIP, Hcy, CSVD overall burden score, and HAMD-24 score(P<0.05). The results of Logistic regression analysis indicated that AIP, Hcy, and CSVD overall burden score were independent factors affecting PSD(P<0.05). The area under the curve(AUC) of the combination of AIP, Hcy, and CSVD overall burden score in predicting PSD was 0.916, which was significantly higher than that of the individual indices(0.732, 0.756, 0.778)(Z=3.564, 2.550, 2.357, P=0.001, 0.011, 0.018). Conclusion The AIP, Hcy, and CSVD overall burden score are independent influencing factors for PSD, and their combined predictive value is high, which can assist clinicians in implementing targeted prevention and treatment measures in a timely manner.
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