METS-IR评分与卒中后抑郁风险的相关性研究
Correlation between Metabolic Score for Insulin Resistance and the Risk of Post-Stroke Depression
DOI: 10.12677/acm.2025.1551526, PDF,   
作者: 辛大慧, 方传勤*：安徽医科大学第二附属医院神经内科，安徽 合肥
关键词: 卒中；卒中后抑郁；胰岛素抵抗代谢评分；Stroke； Post-Stroke Depression； Metabolic Score for Insulin Resistance
摘要: 目的：卒中(Stroke)是一种急性脑血管疾病，分为缺血性和出血性两类，主要由脑血流中断或血管破裂引起。它是全球致残和致死的主要原因之一。卒中后抑郁(post-stroke depression, PSD)是该病最常见的神经精神后遗症之一。近期研究发现胰岛素抵抗代谢评分(metabolic score for insulin resistance, METS-IR)与抑郁具有相关性。本文探讨METS-IR评分与急性卒中患者发生卒中后抑郁风险的关系。方法：前瞻性选取2023年12月至2024年6月在安徽医科大学第二附属医院收治的急性脑卒中患者，对所有入组患者在入院后第7~14天内使用24项汉密尔顿抑郁评定量表(Hamilton Depression Scale, HAMD)进行评分，分为PSD和非PSD组，比较两组间的一般资料和实验室资料，对卒中后抑郁的危险因素进行Logistics单因素分析，选取其中P < 0.05变量进行Logistic多因素分析，并构建相关模型，最后使用ROC曲线评估该模型对PSD的预测价值。结果：卒中后抑郁组METS-IR显著高于非卒中后抑郁组(38.48 vs 36.84, P = 0.026)，该指数联合入院NIHSS、脂蛋白a构建的模型ROC曲线下面积为0.669 (95% CI: 0.601~0.738, P < 0.001)。结论：METS-IR评分与卒中后抑郁的发生风险呈正相关，是发生PSD的独立危险因素。
Abstract: Objective: Stroke is an acute cerebrovascular disease, which is divided into ischemic and hemorrhagic diseases, which is mainly caused by interruption of cerebral blood flow or rupture of blood vessels. It is one of the leading causes of disability and death worldwide. Post-stroke depression (PSD) is one of the most common neuropsychiatric sequelae of the disease. Recent studies have found an association between metabolic score for insulin resistance (METS-IR) and depression. This article explores the relationship between METS-IR score and risk of post-stroke depression in patients with acute stroke. Methods: Acute stroke patients admitted to the Second Affiliated Hospital of Anhui Medical University from December 2023 to June 2024 were prospectively selected, and all enrolled patients were divided into PSD and non-PSD groups using the 24-item Hamilton Depression Scale (HAMD) within 7~14 days after admission. The risk factors of post-stroke depression were analyzed by Logistic univariate analysis, in which P < 0.05 variables were selected for Logistic multivariate analysis, and the correlation model was constructed, and finally the ROC curve was used to evaluate the predictive value of the model for PSD. Results: The METS-IR of the post-stroke depression group was significantly higher than that of the non-stroke depression group (38.48 vs 36.84, P = 0.026), and the area under the ROC curve of the model constructed by combining this index with admission NIHSS and lipoprotein a was 0.669 (95% CI: 0.601~0.738, P < 0.001). Conclusion: METS-IR score is positively correlated with the occurrence of post-stroke depression and is an independent risk factor for PSD.
文章引用：辛大慧, 方传勤. METS-IR评分与卒中后抑郁风险的相关性研究[J]. 临床医学进展, 2025, 15(5): 1546-1554. https://doi.org/10.12677/acm.2025.1551526

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