血浆Nrf2水平对微创引流术后高血压脑出血患者抑郁情绪的影响

摘要：目的 探讨血浆核因子E2相关因子2（Nrf2）水平与微创引流术后高血压性脑出血（HICH）患者抑郁情绪发生的关系。方法 收集2014年3月—2018年1月初次住院的92例采用微创引流术的HICH患者，酶联免疫吸附法（ELISA）检测术后血浆Nrf2水平，应用美国国立卫生研究院卒中量表（NIHSS）于入院时及术后21 d进行瘫痪分级（PG值）。于术后21 d，Zung氏抑郁自评量表（SDS）评定抑郁情绪，根据SDS标准分分为抑郁组（29例）和非抑郁组（63例），比较2组血浆Nrf2水平差异，二分类Logistic回归分析微创引流术后HICH患者抑郁情绪发生的危险因素。结果 抑郁组术后血浆Nrf2水平低于非抑郁组，入院时及第21天PG值均高于非抑郁组（P＜0.05），抑郁组HICH患者SDS标准分与出血量、术后第21天的PG值呈弱正相关（r 分别为0.30和0.27，P＜0.05），与血浆Nrf2水平呈弱负相关（r=-0.35，P＜0.05）；二分类Logistic回归分析显示，高血浆Nrf2水平是微创引流术的HICH患者出现抑郁情绪的保护因素（OR=0.885，95%CI：0.819~0.955）。结论HICH患者微创引流术后血浆Nrf2水平越低，越易出现抑郁情绪。

Effects of plasma Nrf2 levels on depression in patients with hypertension and cerebral hemorrhage after minimally invasive drainage

Abstract：Objective To investigate the relationship between plasma level of nuclear factor E2 related factor 2 (Nrf2)and depression in patients with hypertensive intracerebral hemorrhage (HICH) after minimally invasive drainage. Methods A total of 92 patients with HICH who were hospitalized from March 2014 to Jenuary 2018 were enrolled. Postoperative plasma Nrf2 levels were detected using ELISA. The National Institutes of Health Stroke Scale (NIHSS) expressed as PG values were assessed at admission and on the 21th day after operation. At the 21th day after hospitalization, the Zung Depression Self-rating Scale (SDS) was used to evaluate depression. According to the SDS criteria, the patients were divided into depression group (n=29) and non-depression group (n=63). The differences of plasma Nrf2 levels were compared between the two groups. The risk factors correlated with depression of HICH patients after minimally invasive drainage were analyzed using two-class Logistic regression. Results The plasma Nrf2 level was significantly lower in depression group than that in non-depression group (P＜0.05). The PG values were significantly higher in depression group than those in nondepression group at the admitted and the 21th day after hospitalization (all P＜0.05). For HICH patients in depression group the SDS standard scores were positively correlated with hematoma volume (r=0.30) and PG value at the 21th day after operation (r=0.27, P＜0.05), and which were negatively correlated with the plasma Nrf2 levels (r=-0.35, P＜0.05). The twoclass Logistic regression analysis showed that high plasma Nrf2 level was a protective factor for depression in HICH patients undergoing minimally invasive drainage (OR=0.885, 95%CI:0.819-0.955). Conclusion The lower plasma Nrf2 level after minimally invasive drainage in HICH patients, the more prone to depression.