卒中后抑郁细胞因子蛋白组学初探

目的 初步探讨急性缺血性卒中患者血浆120种细胞因子蛋白水平与卒中后抑郁（post-strokedepression，PSD）发生的关系。方法 入组PSD及非PSD患者各12例，均为卒中发生后3 d内入院的急性缺血性卒中患者，随访至卒中后2周，对患者进行神经功能，认知功能及抑郁、焦虑严重程度评估。患者入院后1 d［卒中后（1.5±0.9）d］清晨6∶30留取空腹时静脉血浆标本，利用人类细胞因子蛋白表达微阵列芯片进行120种细胞因子蛋白组学检测。结果 与非PSD组相比，PSD组4个细胞因子血浆中点信号强度（spot signal intensity，SIs）显示降低，差异有显著性，分别为胰岛素样生长因子1受体（insulin-like growth factor 1 receptor, IGF-IS R）（P =0.021），巨噬细胞炎症蛋白-3β（macrophage inflammatory protein-3 beta，MIP-3 beta）（P =0.033），胎盘生长因子（placental growth factor，PIGF）（P =0.021），血管内皮生长因子（vascularendothelial growth factor，VEGF）（P =0.015），但均未通过错误发现率多重校正，多因素Logi sti c回归分析无阳性发现。血浆胰岛素样生长因子1受体蛋白SIs与患者入院时Barthel指数呈负相关（r =－0.641，P =0.025），与2周后PSD患者汉密尔顿抑郁量表评分（r =0.478，P =0.005）及汉密尔顿焦虑量表评分（r =0.674，P =0.016）呈正相关。结论 本研究的数据尚未发现能独立预测卒中急性期PSD风险的血浆细胞因子，但3种生长因子水平的异常提示PSD可能存在突触可塑及神经再生障碍。

Cytokines Proteomic Study in Post-Stroke Depression: A Preliminary Study

Objective To investigate the association between post-stroke depression (PSD) and the level of
cytokines in plasma.
Methods Plasma spot signal intensity (SIs) of 120 cytokines were measured by Human Cytokine
Antibody Array G-Series 1000 in 12 patients with PSD and 12 non-PSD controls who admitted to the
hospital within the first 3 days after stroke onset. The diagnoses of PSD were made in accordance with
DSM-IV criteria. The 17-item Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety
Scale (HAMA) were used to screen for depressive and anxiety symptoms on days 14 after admission.
Results Plasma SIs of 4 cytokines (insulin-like growth factor 1 receptor [IGF-I SR], macrophage
inflammatory protein-3 beta [MIP-3 beta], placental growth factor [PIGF], vascular endothelial
growth factor [VEGF]) were significantly lower in PSD patients than in non-PSD patients, although
these findings were not significant after the false discovery rate (FDR) correction for multiple
testing to be applied. No cytokine was independently associated with incidence of PSD at the acute
stage of stroke. Plasma SIs of IGF-I SR showed a negative correlation with the Barthel index (r =-
0.641, P =0.025) 1 day after admission and showed positive correlations with the HAMD (r =0.478,
P =0.005) and HAMA scores (r =0.674, P =0.016) 14 days after admission.
Conclusion Plasma levels of cytokines after ischemic stroke can't serve as a biological marker
to predict the incidence of PSD. Dysfunction of synaptic plasticity and neurogenesis may play a
causative role in PSD.