作者：梁浩，金曼，谷剑，陈淑霞，吕佩源

单位：

1.河北省人民医院心脏中心2.河北省人民医院神经内科河北省脑网络与认知功能重点实验室

Units：

1.Heart Center, Hebei General Hospital, Shijiazhuang 050051, China 2.Department of Neurology, Hebei General Hospital/Hebei Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang 050051, China

关键词：

抑郁; 心肌梗死; 中性粒细胞/淋巴细胞比值; 超氧化物歧化酶;

Keywords：

Depression; Myocardial infarction; Neutrophil-lymphocyte ratio; Superoxide dismutase

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.165

Funds：

2022年度河北省医学科学研究课题计划（20220821）；河北省自然科学基金资助项目（H2022307075）

摘要：

目的 探讨炎症指标和氧化应激指标对急性心肌梗死患者PCI后发生抑郁的预测价值。方法 选取2021年就诊于河北省人民医院心脏中心且行PCI的AMI患者282例。采用汉密尔顿抑郁量表24(HAMD-24)评估患者是否存在抑郁，HAMD-24评分>20分者被认为存在抑郁，将其作为抑郁组（n=73），其余患者作为非抑郁组（n=209）。比较两组一般资料、炎症指标[WBC、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、单核细胞/淋巴细胞比值（MLR）、全身免疫炎症指数（SII）、平均血小板体积（MPV）]、氧化应激指标[超氧化物歧化酶（SOD）]。采用多因素Logistic回归分析探讨AMI患者PCI后发生抑郁的影响因素。绘制ROC曲线以评估相关指标对AMI患者PCI后发生抑郁的预测价值。结果 抑郁组收缩压、WBC、NLR、PLR、MLR、SII、MPV、SOD高于非抑郁组（P<0.05）。多因素Logistic回归分析结果显示，收缩压升高、NLR升高、SOD升高是AMI患者PCI后发生抑郁的独立危险因素（P<0.05）。ROC曲线分析结果显示，NLR、SOD预测AMI患者PCI后发生抑郁的AUC分别为0.749[95%CI(0.673,0.825)]、0.617[95%CI(0.545,0.688)]，最佳截断值分别为4.165、141.85 U/ml，灵敏度分别为61.6%、68.5%，特异度分别为89.5%、58.9%。结论 NLR升高、SOD升高是AMI患者PCI后发生抑郁的独立危险因素，其中NLR对AMI患者PCI后发生抑郁具有一定预测价值，而SOD的预测价值较低。

Abstract：

　Objective To investigate the predictive value of inflammation and oxidative stress indicators for depression in patients with acute myocardial infarction after PCI. Methods A total of 282 AMI patients who underwent PCI at the Heart Center of Hebei General Hospital in 2021 were selected. Hamilton Depression Scale 24 (HAMD-24) was used to evaluate depression in patients. Patients with HAMD-24 score > 20 were considered having depression, and they were classified as the depression group (n=73) , while the rest patients were classified as the non-depression group (n=209) . General data and inflammatory indicators [WBC, neutrophil lymphocyte ratio (NLR) , platelet lymphocyte ratio (PLR) , monocyte lymphocyte ratio (MLR) , systemic immuneinflammation index (SII) , mean platelet volume (MPV) ] , oxidative stress indicators [superoxide dismutase (SOD) ] were compared between the two groups. Multivariate Logistic regression analysis was used to explore the influencing factors of depression in AMI patients after PCI. ROC curve was drawn to evaluate the predictive value of relevant indicators for depression in AMI patients after PCI. Results Systolic blood pressure, WBC, NLR, PLR, MLR, SII, MPV and SOD in depression group were higher than those in non-depression group (P < 0.05) . Multivariate Logistic regression analysis showed that increased systolic blood pressure, increased NLR and increased SOD were independent risk factors for depression in AMI patients after PCI (P < 0.05) . ROC curve analysis showed that the AUC of NLR and SOD for predicting the occurrence of depression in AMI patients after PCI were 0.749 [95%CI (0.673, 0.825) ] and 0.617 [95%CI (0.545, 0.688) ] , and the optimal cut?off values were 4.165 and 141.85 U/ml, the sensitivity was 61.6% and 68.5%, and specificity was 89.5% and 58.9%, respectively. Conclusion Increased NLR and SOD are independent risk factors for depression in AMI patients after PCI, and NLR has certain predictive value for depression in AMI patients after PCI, while SOD has a lower predictive value.

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