脑卒中患者血清炎症细胞因子水平与脑卒中后抑郁之间的关系：荟萃分析和系统回顾

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-02-11 DOI:10.1016/j.jpsychores.2025.112050

Yao Zhou , Lijuan Zhao , Yunzhu Tang , Shuxia Qian

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引用次数: 0

摘要

脑卒中后抑郁（PSD）是脑卒中后常见的神经精神并发症。脑卒中事件引发的神经炎症可能是其诱发因素。方法系统检索截至2024年12月22日的所有电子数据库。观察性研究比较PSD和非PSD患者的细胞因子水平。进行敏感性分析、亚组分析和meta回归来评估稳健性、探索异质性和确定效果修饰因子。结果共纳入26项研究，6573例急性脑卒中患者，其中2453例发生PSD。与非PSD患者相比，PSD患者年龄更大（63.7岁对62.8岁），女性患者更多（36.4%对35.1%）。PSD患者血清IL-1β (SMD = 0.35, 95% CI = [0.07, 0.63], p = 0.02)、IL-6 (SMD = 0.74, 95% CI = [0.50, 0.97], p <；0.001),地震(SMD = 0.49, 95% CI = [0.13, 0.86], p = 0.007),肿瘤坏死因子-α(SMD = 0.44, 95% CI = [0.15, 0.72], p = 0.003)和干扰素-γ(SMD = 0.11, 95% CI = [0.02, 0.19], p = 0.01),而il - 10水平没有显著差异(p = 0.06)。IL-6水平在1、3和6个月时仍与PSD诊断相关。meta回归确定女性比例(IL-6: p = 0.043；IL-10: p = 0.024)，平均年龄(IL-18: p = 0.015；肿瘤坏死因子-α:p = 0.040), BMI(地震:p = 0.019),比例和糖尿病(il - 6: p = 0.009;TNF-α: p = 0.033)为显著调节因子。结论炎性细胞因子可能作为PSD的生物标志物，为PSD的病理生理学和潜在的诊断工具提供了新的思路。普洛斯彼罗注册号：CRD42024548753。

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Association between serum inflammatory cytokines levels and post-stroke depression among stroke patients: A meta-analysis and systematic review

Background

Post-stroke depression (PSD) is a common neuropsychiatric complication after stroke. Neuroinflammation triggered by the stroke event may be its predisposing factor.

Methods

We systematically searched all electronic databases up to December 22, 2024. Observational studies comparing cytokine levels between PSD and non-PSD patients were included. Sensitivity analysis, subgroup analysis, and meta-regression were conducted to assess robustness, explore heterogeneity, and identify effect modifiers.

Results

A total of 26 studies with 6573 acute stroke patients were included, of whom 2453 developed PSD. PSD patients were older (63.7 vs. 62.8 years) and included more females (36.4 % vs. 35.1 %) than non-PSD patients. PSD patients had significantly higher serum levels of IL-1β (SMD = 0.35, 95 % CI = [0.07, 0.63], p = 0.02), IL-6 (SMD = 0.74, 95 % CI = [0.50, 0.97], p < 0.001), IL-18 (SMD = 0.49, 95% CI = [0.13, 0.86], p = 0.007), TNF-α (SMD = 0.44, 95 % CI = [0.15, 0.72], p = 0.003) and IFN-γ (SMD = 0.11, 95 % CI = [0.02, 0.19], p = 0.01), while IL-10 levels showed no significant difference (p = 0.06). IL-6 levels remained associated with PSD diagnosis at 1, 3 and 6 months. Meta-regression identified female proportion (IL-6: p = 0.043; IL-10: p = 0.024), mean age (IL-18: p = 0.015; TNF-α: p = 0.040), BMI (IL-18: p = 0.019), and diabetes proportion (IL-6: p = 0.009; TNF-α: p = 0.033) as significant moderators.

Conclusions

Inflammatory cytokines may serve as biomarkers for PSD, offering insights into its pathophysiology and potential diagnostic tools.

Prospero registration number: CRD42024548753.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.