Relationship between cerebral hemorrhage and depression occurrence after craniocerebral injury surgery

Abstract

Objective To explore the relationship between cerebral hemorrhage and the occurrence of depression after craniocerebral injury surgery. Methods From March 2015 to March 2017, 70 patients with craniocerebral injury in our hospital were selected as the subjects of study. They were divided into the observation group (n=30) and the control group (n=40) according to whether there was cerebral hemorrhage after operation. The National Institutes of Health Stroke Scale score (NIHSS), Hamilton Depression Scale score (HAMD), Glasgow Coma Score (GCS) and the levels of interleukin (IL)-1, IL-6 and high sensitivity C-reactive protein (hs-CRP) in patients with different degrees of cerebral hemorrhage were compared. The correlation between HAMD score and other indexes was analyzed. The influencing factors and independent risk factors of depression were analyzed. Results The levels of NIHSS, HAMD score and serum IL-1, IL-6 and hs-CRP in the observation group were higher than those in the control group after operation (t=13.655, 36.587, 45.274, 46.334, 70.489, P<0.05), while the GCS score was lower than that in the control group (t=15.517, P<0.05). Compared with mild and moderate cerebral hemorrhage, the NIHSS, HAMD scores and serum IL-1, IL-6 and hs-CRP were higher in patients with severe cerebral hemorrhage (F=8.825, 10.254, 23.615, 18.745, 7.245, P<0.05) , while the GCS score was lower (F=7.459, P<0.05). The correlation analysis showed that the postoperative HAMD score was positively correlated with NIHSS score and serum IL-1, IL-6 and hs-CRP (r=0.289, 0.364, 0.333, 0.258, P<0.05) and negatively correlated with the GCS score (r=-0.276, P<0.05). Univariate analysis showed that the level of culture, personality, cerebral hemorrhage degree and serum IL-6 and hs-CRP were the influencing factors of postoperative depression in patients with craniocerebral injury (t or χ2=6.076, 6.300, 8.361, 30.224, 99.575, P<0.05). Multivariate analysis showed that cerebral hemorrhage and hs-CRP were an independent risk factor for postoperative depression (P<0.05). Conclusions Cerebral hemorrhage after craniocerebral injury is closely related to the occurrence of depression, which may be related to the increase of stress-induced inflammatory factors after cerebral hemorrhage. Key words: Craniocerebral trauma; Postoperative hemorrhage; Cerebral hemorrhage; Depressive disorder