新疆医学第53卷·论著·脑小血管病总体负担预测卒中后抑郁的价值分析张迎,周豪,马超,王俊(新疆维吾尔自治区人民医院放射影像中心乌鲁木齐830001)摘要:目的评估脑小血管病(cerebralsmallvesseldisease,CSVD)总体负担预测急性缺血性卒中患者发生卒中后抑郁(poststrokedepression,PSD)的价值。方法以317例急性缺血性卒中患者为研究对象,根据卒中发病后3个月时是否发生PSD分为PSD组和非PSD组,通过单因素和多因素分析明确CSVD总体负担与PSD的独立相关性,并采用接收者工作特征(receiveroperatingcharacteristics,ROC)曲线评估预测价值。结果87例患者(27.4%)发生PSD,调整年龄、糖尿病、空腹血糖、卒中分布和高血压后,CSVD总体负担(OR:1.297,95%CI:1.104-1.583,P=0.012)和NIHSS评分(OR:1.185,95%CI:1.079-1.376,P=0.007)是PSD的独立危险因素。ROC曲线显示,CSVD总体负担预测PSD的AUC为0.780(SE:0.029,P<0.001,95%CI:0.723-0.837)。最佳截断值为2,灵敏度和特异度分别为79.3%和66.5%。结论CSVD总体负担具有应用于PSD预测的潜力。关键词:急性缺血性卒中;卒中后抑郁;脑小血管病总体负担;预测价值中图分类号:R445.2文献标识码:A文章编号:1001—5183(2023)01—50—04ValueoftotalburdenofcerebralsmallvesseldiseaseinpredictingpoststrokedepressionZHANGYing,ZHOUHao,MAChao,WANGJun(RadiographyCenter,People'sHospitalofXinjiangUygurAutonomousRegion,Urumqi,830001,China)Abstract:ObjectiveToevaluatethevalueoftotalburdenofcerebralsmallvesseldisease(CSVD)inpredictingpoststrokedepression(PSD)amongacuteischemicstrokepatients.MethodsAtotalof317patientsundergoingacuteischemicstrokewereincludedinthisstudyandweredividedintoPSDgroupandnon-PSDgroupaccordingtooccurrenceofPSDatthreemonthsafterstrokeonset.UnivariateandmultivariateanalysiswereperformedtoidentifytheindependentassociationbetweentotalburdenofCSVDandPSD.Receiveroperatingcharacteristics(ROC)curvewasusedtoevaluatethevalueoftotalburdenofCSVDinpredictingPSD.ResultsEighty-sevencasesoccurredPSD(accountingfor27.4%).TotalburdenofCSVD(OR:1.297,95%CI:1.104-1.583,P=0.012)andNIHSSscore(OR:1.185,95%CI:1.079-1.376,P=0.007)wereindependentriskfactorsofPSDafteradjustingforage...